The Center of Light Institute of Sound Healing and Shamanic Studies 
We Accept:       for all programs and services 
The Center of Light Home Page  

Registration Form for The Center of Light Programs
The Center of Light, PO Box 389, Ascutney, VT  05030  USA, 
Phone: 802.674.9585;  Fax:   802.674.9586;    E-mail:  info@sunreed.com 
Please print out or copy and paste into a word document, fill out and mail, or fax with payment or credit/debit information:
If you are participating in an outdoor program, Sacred Journey or Tour, in the US, or elsewhere, please, also fill out our Emergency Contact Information Form and Waiver here.  


Name .................................................................................................................................................

Address  ............................................................................................................................................................

City .........................................................  State/Province ......................  Zip or Postal Code ..........................  Country   .........................................

Telephone/Fax  …………………………………………………........................  Cell phone  .......................................………………………………….................

E-mail Address     .........…………………………………………...........................................................

Name of Workshop or Sacred Journey I wish to attend ........................................................................................................................................

Dates of Workshop/ Journey   ................................................     Full Cost of workshop: ................................. 
 
Enclosed is ....................................   for deposit;      or, ...............................  for payment in full

   If using Credit Card:  Please charge to my credit/debit card, this amount ........................................  for deposit,

          or    ...............................  for payment in full.  (All funds in US Dollars)
If deposit, please charge the balance
      on my credit/debit card (amount)  ..............................  on (date)..............................
For Credit/Debit Card Payment (MC, VISA, or AmEx only):   mail, fax or call with card #, expiration date, SEC #, name on the card, and your billing address for the card. 
You may register on line via our secure server, see below.
You may, also, pay via PayPal, via the e-mail method, using 'zacciah@sunreed.com' as our e-mail contact.
Card Number  ....................................................................        Ex Date:  ................................             3 Digit SEC code on back of card  _______
                                                                                                                        If different:
Name on Card:  ........................................................................ Billing address:  ...................................................
 
                                                                                ................................................................................................
   
  Date    …………………………………         Signature.........................................................................................
With my signature I acknowledge and accept the conditions of this workshop & registration as set forth in the information contained in The Center of Light's registration information for this specific program, or, in many 2 day programs, in the Registration web pages, including any non-refundable deposits and/or program costs.   I understand that registration in a program is not acceptance into the program, until my payment is received and processed.
To register on line, go to our Secure page, and fill in your contact and charge information, enter the workshop title on the "instruments' line and workshop and/or deposit amounts. (other instrument info requests, taxes, or shipping fees, etc, do not apply on that secure order form.)

If you are participating in an outdoor program, Sacred Journey or Tour, in the US, or elsewhere, please, also fill out our Emergency Contact Information Form and Waiver here.


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 The Center of Light Institute of Sound Healing and Shamanic Studies
   Zacciah Blackburn,    220 Hidden Glen Rd. ,    P.O. Box 389 ,     Ascutney, VT  05030  USA
   Phone:   (802) 674-9585 
Fax:   (802) 674-9586    E-Mail info@sunreed.com
  C   2005-11 Zacciah, The Center of Light