Dark Moon, Dark Goddess
Summer Weekend Retreat for Women

Registration Form

Rates: Early Registration (before March 15): $350 for one/$625 for two. (Come with a grrl friend, and save $75!) After March 15: $400/$725. On Site: $450/$825. All meals are catered, and included in the rates. Income sensitive sliding scale available upon request. Work-trades available (advance and on-site), but must be agreed upon in advance. Barter proposals will be considered. Limited scholarships may be available.

Workshop is limited to 15 registrants, so sign up early!

I would like to donate $____________________ to the scholarship fund.

Total enclosed: $_______________

Date Paid In Full:_______________

Please fill out a registration sheet for each registrant. Make checks payable to LaSara FireFox. Print form and send, along with payment, to:
Chaos Star Productions
P.O. Box 1503
Ukiah, CA, 95482

Name:_____________________________________________________Phone:_______________________

E-Addy:____________________________________________________________________ Age:_________

Street/Address___________________________________________________________________________

City:__________________________________________________ State:_______ Zip:__________________

I am (circle one): Vegan. A vegetarian. An Omnivore.

I have a restricted diet. Details:_________________________________________________________________

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