____ Enclosed is a $250.00 deposit for 6D / 5N Maui Yoga Retreat 
    December 27, 2010 – January 1, 2011 


____ Total cost: $1650.00
          Full payment due December 13, 2010 
      
         * Deposit due December 1, 2010  
         

Name __________________________________________________

Address _______________________________________________

Home phone ____________________________________________

Business Phone ________________________________________

Email Address  ________________________________________

Date of Birth _________________________________________

Special Interest ______________________________________

MAIL TO:
Ann Barros
341 26th Avenue
Santa Cruz, CA  95062
(831) 475-8738 Phone 
(831) 475-8738 FAX  
email Ann at abarros@pacbell.net