Registration form We are delighted you will be joining us this workshop "Connection as a way of life" with Sal Gencarelle. Please complete the details below with payment and we will be in touch shortly.Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email address* How did you hear about the workshop?* Do you have special dietary needs for the workshop? If you would like to discuss this further please contact us via the contact page.To reserve your place please pay a deposit of $200 with balance due by February 22nd (early bird) or April 10th. How would you like to pay?*please selectFull Payment - Early Bird - $670Full payment - $730Deposit - $200(Details on how to pay will be displayed after the registration is submitted).Message boxNameThis field is for validation purposes and should be left unchanged.