2015 Kauai Yoga Shakti Program 2015 December 28 - 04 January 2016, (7 Nights) Island of Kauai

Booking & Registration Form with your photograph This is page 1 of a 3-page Registration Form. Please fill in all pages and email to:

vedanet@aol.com  or mail to American Institute of Vedic Studies, PO Box 8357, Santa Fe NM 87504-8357 USA

_______YES! Register me for the following: (One form per registrant, please) Study Program is from 2015 Dec. 28 at 2:00 Pm – 2016 January 1 at 6:00 Pm (5 Days) Jan. 1, 6:00 Pm – Jan 4, 2:00 Pm you will be free to tour the island. Cost of Program -USD 2495.00 for 7 nights Early Registration discount up to September 1, 2015 – USD 2250.00 A non-refundable deposit of USD 750.00, is payable immediately to book your space. Remaining balance is payable by November 30, 2015. Optional Na Pali Coast Cruise: 150 USD payable at site. PROGRAM/ RETREAT PRICE INCLUDES: Retreat: 2015 December 28 – 2016 January 1 at 6:00 Pm - 10:30 Brunch, afternoon Tea and Dinner. January 2 – 4, 2016 at 2:00 Pm - only accommodation is given. Meals and sightseeing will be at your own expense. Kitchen facilities can be used for preparing your personal meals. Accommodation is on twin sharing basis. Tour of the Hinduism Today Monastery on the Island of Kauai. You are strongly advised to make your International flight bookings to the Island of Kauai as soon as possible, as cheaper tickets tend to get sold nearer to the date of travel. The airport to arrive at in Kauai is LIHUE. Please advise us your Flight Information as soon as the tickets have been booked. TRAVEL INSURANCE Cancellation Insurance is strongly recommended as no exceptions to the cancellation provisions can be made. Please understand that any financial loss or emergency medical expense will be assumed by you. Please read the terms and conditions and fully understand the cancellation penalties. RETREAT CANCELLATIONS The following cancellation charges as a percentage of total price apply subject to a minimum cancellation amount of $750.00: Before 90 days $750 60–90 days or more before departure 50% 30-60 days before departure 75% 0-30 days before departure/No Shows 100% __________I have read and understood the cancellation and travel insurance clauses

This is page 2 of a 3-page Registration Form and Your Photograph. First Name (as in passport): ___________________________________________________ Last Name:___________________________________________________________________ Occupation: _________________________________________________________________ Birth Data:____ (Month/Day/Year) Time________ Place Address:_____________________________________________________________________ City: _________________________State: ________Zip: _______Country:_______________ Day Ph: ____________________________ Eve Ph: _________________________________ Email: ______________________________________________________________________ Sex: ______________Citizenship: _____________________________ If sharing a room, I want to share with: _________________________________________ Contact Person in case of emergency___________________________________________ ______________________________________________________________________________ Any Special Requirements ____________________________________________________ Would you like a Personal Vedic Consultation with Yogini Shambhavi? (Cost 150 USD payable at the retreat): ______ Have you been to Kauai before? _______________________________________________ Have You Attended any of our Programs Before? Please specify _________________________________ Signed and Dated____________________________________________________________

This is page 3 of a 3-page Registration Form. PAYMENTS Check or Money Order Payments Enclosed is my Check or Money Order for $ ___________________________________________ Make payable and mail to: American Institute of Vedic Studies PO Box 8357, Santa Fe NM 87504-8357 USA Bank Wire Transfers: Please contact us by email and we will provide you our bank information. Paypal Tranfers: You can transfer your payment to American Institute of Vedic Studies at vedicinst@aol.com or contact us for more information. CREDIT CARD PAYMENTS BY PHONE Please call in your credit card information to the American Institute of Vedic Studies (505-983-9385), credit card type, number, expiration and security code. You can leave the information on our voice mail if no one is in to answer the phone. Also email us your billing address for the card. BY MAIL – Please verify your registration before sending in mail payments Please furnish your credit card information and sign: Please charge my Visa / Mastercard / American Express credit card (circle one) for the Amount of US$____________________. Credit Card Number:__________________________________________________________ Expiration Date:____________________Security Code:_____________________________ Billing address if different than address already given: ______________________________________________________________________________ City: ___________________State: ______________ Zip: _________ Country: ________ Signed: ___________________________________________ Date: ____________________