Renovate Your Life Retreat
September 27, 2012 – September 30, 2012
Hope Springs Institute
Give yourself the gift of investing in two and a half days to
break free from what’s holding you back and discover the
courage, power, and passion to fulfill your dreams.
Full Name: ___________________________(First name for badge)______________________________
Preferred Mailing Address: ______________________________________________________________
City: ________________________State/Province: ___________Zip/Postal Code: _________________
Country: __________ Telephone: (______)____________ Email: _______________________________
1. Registration Fee (All fees listed in U.S. Funds.) Includes shared room, 8 meals, and retreat materials.
POSTMARKED & PAID
PLEASE CHECK APPROPRIATE REGISTRAION FEE: BEFORE/ON AUGUST 1 AFTER AUGUST 1
Renovate Your Life Retreat $639 $689
Please list any ADA Special Needs: ____________________________________________________________
Please list any Dietary Restrictions: ___________________________________________________________
Please list an Emergency Contact: _____________________________________________________________
Cancellations/Changes and Refunds: Fees for missed meals, late arrivals, and early departures will not be
refunded. Fees will be refunded, less a $50.00 processing fee, if cancellation or change resulting in a refund is
received in writing no later than September 1, 2012. After that date, fees are non-refundable.
PAYMENT METHOD - Check or Money Order must be in U.S. funds payable to: Donna Johnson. There will be a
$25.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation/receipt and
further information will be mailed.
Please check appropriate box: Check Money Order PayPal (credit cards accepted through PayPal – an invoice
will be sent to you for payment if this box is checked)
Please mail completed registration form to: For More Information Contact:
Donna Johnson, Renovate Your Lifestyle Debra McNealy-Hoelscher
1909 Claremont CC Commons firstname.lastname@example.org
Normal, IL 61761 309.838.7433
Program information at http://renovateyourlifestyle.com/events/retreat