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Please complete this travel reservation form completely. You must enter legal name as it appears on your travel documents. You will receive an email confirmation from us once this form is complete and payment has been processed. If you have any questions while completing this form, please contact us at info@iamcoachk.com.
**Please note: A valid passport is required to travel to Mexico and all payments are non-refundable. By completing your registration you are agreeing to these terms.
First Name
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Last Name
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Email Address
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Street Address
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
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Indiana
Iowa
Kansas
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Louisiana
Maine
Maryland
Massachusetts
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Montana
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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Washington DC
Zip Code
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Phone Number
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Roommate
How did you find out about this retreat?
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Choose Your Package
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SINGLE OCCUPANCY PAID IN FULL ($900)
SINGLE OCCUPANCY PAYMENT PLAN ($1000)
DOUBLE OCCUPANCY PAID IN FULL ($700)
DOUBLE OCCUPANCY PAYMENT PLAN ($800)
*Your Package Includes a Goodie-Filled Travel Tote, T-shirt & Workshop Tools.
Please include T-shirt size below:
T-Shirt Size
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Small
Medium
Large
X-Large
XXL
3XL
Enter deposit amount of at least $100.00 **Each person must pay their own deposit
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Yes, I accept your terms and conditions.
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