Martha's Vineyard Holistic Retreat - Registration Form
	Print this form out, fill it in, and mail it, fax it, or phone it in. Contact information is listed below.

Yes! I am Interested in signing up for the Retreat for:

______________________

Days

Name:

___________________________________________

Date:

_____________

Phone:

____________________________

Fax:

____________________________

Address:

_____________________________________________________________

Reason for coming to Retreat:

____________________________________________

Referral Source:

_____________________

Method of Payment:

_____________________

Credit Card:

___________________________

Amount:

___________________________

Card Number:

___________________________

Exp. Date:

___________________________

To reserve your space please send your Retreat Registration and Menu Registration Form and a 50% down payment to: Martha's Vineyard Holistic Retreat Post Office Box 732 Vineyard Haven MA 02568 Fax: (508) 696-9235 Phone: (508) 693-0001

1. Balance due 1 week prior to arrival date. 2. You may authorize us to charge the deposit on Visas or Mastercard by letter, phone or fax. 3. Deposits must be received within 5 business days of reservation or they are subject to cancellation. 4. No refunds on late arrivals or early departures. 5. Cancellations must be received 21 days prior to arrival for a refund, less a 20 % processing fee. 6. Rooms subject to Massachusetts State Room tax and Dukes County Room Occupancy Tax.

Retreat Menu Order Form

	Therapy:	Code:	Therapy:	Code:
	Therapeutic Massage	TM	Spa Pass	SP
	Body Wraps	BW	Yoga (private or group)	Y
	Private Consultation	PC	Meditation	M
	Sauna Detox	SD	Music therapy	MT
	Alpha Spa	AS	Mineral Baths / Aroma	MB
	Colon therapy	CT	Nutritional Program	NU
	Feet Reflexology	FR	Special Request	SR

Enter appropriate code on line below to choose one custom therapy per day.

	SUN	MON	TUES	WED	THU	FRI	SAT
	____	____	____	____	____	____	____

Home || Registration Form || Programs || Rates || Spa Treatment and Facilities || Credentials Martha's Vineyard Holistic Retreat 209 Franklin Street Post Office Box 732 Vineyard Haven, MA 02568 tel: (508) 693-0001 fax: (508) 696-9235 800 595-9996 Copyright © Martha's Vineyard Holistic Retreat 1998