Registration Form

 

The Compassionate Journey

to Berlin, Germany May 13-20, 2008

 

with Brian and Lisa Berman

A Compassionate Listening Delegation

 

Please print & carefully fill out the following form, then mail with your deposit to:

Berman Healing Arts

P.O. Box 975, Suquamish, WA 98392    USA

 phone: (360) 697-2288

email: info@BermanHealingArts.com

 

Name:

 

Address:

 

City:                                                                            State/Country:                               

 

Zip:

 

Telephone - Day:                                                Telephone - Evening:

 

Email:

 

Age:                                                                            Country of Citizenship:                                

Occupation (optional):                                             Gender: M______  F______                   

Religious affiliation/practice (optional):                

 

Languages spoken:

 

What draws you to participate in this delegation? (use the back if you need more room)

 

 

 

What do you hope to get from participating in this delegation?

 

 

 

Participants are expected to have good communication skills and a commitment to conflict resolution. What are your strengths in this area?

 

 

 

How did you learn about this delegation?

 

 

 

Special Diets: The food prepared for us is vegetarian (mostly organic). If you have a special diet, please let us know and we will check to see if our host can provide what you need. If not we suggest that you bring or purchase in Berlin the special foods that you require. Please indicate your dietary needs:

 

 

Reservations: Your $300 deposit will secure your spot on this trip, space is limited. Balance is due by March 13, 2008.

 

Payment: The cost for the delegation to Berlin is $1,330* or $1,250* if registered by January 15, 2008. *Hotel and airfare are additional and purchased separately. We accept payment by check and credit card. Full trip payment is expected 60 days before the trip unless other arrangements are made with us. We will provide the contact information for you for the mit-Art Hotel where we will stay.

 

For more information please contact Brian and Lisa Berman at info@BermanHealingArts.com or call 360-697-2288.

 

This project offers the possibility of deep healing and the facilitators provide a safe, supportive environment. You will hear personal stories that might bring up a full range of emotions. As a participant you are agreeing to take full responsibility for your health and well-being throughout the delegation.

 

 

Cancellation Policy for the Compassionate Journey

If you must cancel your trip, a cancellation fee will apply. Cancellations must be received in writing or by email. The following cancellation fees apply:
* 60 days or more before event: $100 will be retained for administrative costs.
* 30 - 60 days: 30% of the trip cost will be retained unless you find someone to take your place.
* less than 30 days and "no-shows": we're sorry but we cannot provide any refund in this case.
* No partial refunds will be granted. Our trips are quoted as a package and credits are not given for unused portions.

 

If we have to cancell the Compassionate Journey by January 18th because of a lack of registrations, we will refund your $300/Euro 300 deposit in full.

We will confirm in writing that the program will take place by this date or sooner.

We recommend that you purchase travelers insurance if you purchase your airline tickets before January 18th, 2008.


 

 

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Signature                                                                                                          Date

 

 

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Emergency Contact (Relation)                                                                Phone