Flute Haven 2020 Accomodations and Meals Form


*Flute Haven 2020 Accomodations and Meals* Hosted by Expressive Therapy Concepts Accomodations Policies	Registrar: Vera Shanov Phone: 203-454-1479 Cell: 203-644-4596 Fax: 203-222-0895 Email: vera@shanov.com 6 Fieldcrest Road Westport, CT 06880
Secure Accomodations and Meals Form

This registration form is protected by Secure Socket Layer (SSL) strong encryption.
All information entered here is private and secure.

1 » Accomodations Info:

2 » Billing Info:
(if different from “Accomodations Info”)

First Name

Last Name

Address

City or town

State or province

Zip or postal code

Country

United States

Home Phone

Cell Phone

E-mail address

First Name

Last Name

Address

City or town

State or province

Zip or postal code

Country

United States

Billing Phone

E-mail address

3 » Details:
Check this box if you require a handicap-accessible room.
Roommate Preference:
Please describe any specific dietary restrictions you have:

4 » Accomodations and Meals:

This event is hosted by Expressive Therapy Concepts, a not-for-profit organization.
Your contributions may be tax-deductible — please consult your tax advisor.

Accomodations
and Meals

Single Room with meals ($833) – shared bath in the hall.
Double Room with meals ($733) – shared bath in the hall.
Commuter — if you are not lodging at Pendle Hill — includes lunch and dinner and the activity fee we pay for use of the facilities. ($440)
Commuter bringing their own meals — for participants with highly restricted diets who cannot be accomodated by the Pendle Hill kitchen. This covers the activity fee we pay for the use of the Pendle Hill facilities. Please contact us before selecting this option! ($250)

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Adjustment

For administrative use only:
Adjustment amount:
Adjustment details:

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Total Fee

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Fee due at time of registration.

5 » Payment:

(select one)

Credit card payments are processed through PayPal.
You can use your credit card even if you do not have a PayPal account.

If you are paying by check or money order,
please make them payable to “Expressive Therapy Concepts”
and send to Vera Shanov, 6 Fieldcrest Road, Westport, CT 06880.
If you prefer to register by telephone, contact Vera Shanov at 203-454-1479 (cell 203-644-4596).

Notes:

If you are requesting a double room and know a person who is joining us and wish to share a room with them, enter their name in the Roommate Preference box above. Otherwise, we will make a best effort to match up roommates.
The meal program includes all on-site meals, starting with dinner on Sunday and ending with breakfast on Friday.
Lunch after the closing session on Friday is not included — to accomodate those participants who wish to get on the road.
Please see http://www.FluteHaven.com/register.htm for the complete cancellation policy.