Tatau Pounamu Registration Form • Kawai Purapura

Friday, 5th – Monday, 15th January 2018

Personal Details

First Name*

Last Name*

Title*

Address*

City/Town*

Email*

Mobile Phone

Home Phone

Work Phone

Country of Residence*

Occupation*

Emergency Contact Name*

Emergency Contact Telephone Number*

• How did you hear about our course?

Other, please specify

Experience:

How would you rate your current level of understanding of Maori tikanga (customs and culture)*

Comments:

Provide brief details of any medical condition or injuries you have: (Include medications, psychiatric treatment, nervous disorder, etc.)*

ADDITIONAL INFO:

All accommodation is marae-style (sleeping in one venue) at all locations for this course. Private Accommodation is available only at Kawai Purapura Retreat Centre if required, and this is an additional cost.

Would you like to book Private Accommodation at Kawai Purapura?*

Yes
No

Type of room*

Single
Twin Share

Please indicate if you require all your meals to be Strictly Vegetarian*

Any special health or dietary considerations

PAYMENT DETAILS

The following payment has been made via Eventbrite*

A deposit of $NZ500 (this is non-fundable and Early Bird balance should be paid by 5 Dec 2017)
Payment of $NZ3,100 Early Bird price (ends 5 Dec 2017)

Terms and Conditions

Payment Policy: Deposit of $500.00 and fees paid up until 30 days prior to commencement date are non-refundable

Full payment is due by 5 December 2017 and participants agree to pay any outstanding balance no later than this date.

Disclaimer: We reserve the right to alter content and presenters on this course without notice due to unforeseen circumstances. If travelling from out of town, please consider travel insurance. We reserve the right to cancel the course at any time.

Use of Photographic Material: Any photographs taken by Kawai Purapura of attendees during this course may be used by Kawai Purapura for marketing purposes. If you do not wish us to use photos with your image, please advise us to Kawai Purapura Retreat Centre, in writing before the course starts.

By checking this box you agree to the terms and conditions above*

I agree