Fall Spirit Retreat

“OCTOBER SPIRIT RETREAT” Lake Tealwood in ROLLA, MO (Sponsored by The Little Shoppe of Auras) Couples/ Shared Lodging registration - $425.00 Single Registration - single lodging - $275.00 Lodging and meals provided (2 nights/3 days) Smoke Free environment – Smoking is allowed outside only.. 4 rooms are equipped with 2 beds to accommodate room mates comfortably. These rooms will be on a first come first serve basis for pre-registered attendees sharing accomodations.

Full payment Required by September 23rd

______Enclosed is my Couples/ Shared Lodging Registration fee of $425.00.

______Enclosed is Singles / Single Lodging Registration fee of $275.00

If charging a credit card: Mastercard/Visa #______Exp date_____ CV numbers on back of card…last 3 numbers needed (xxx xxx xxx ______) Billing address for card Street address______and Zip code______

Please register me / us for the 2006 October Spirit Retreat and forward a confirmation, receipt, map to the lodge, and the itinerary to:

Name:______(*shared lodging)Name:______

Address:______

City/State______Zip______

Phone______****Email______

Date of Registration:______

Special Dietary Needs: (Please describe specific needs if any, i.e. no salt, diabetic, etc..)______

Make Checks/money orders payable to: The Little Shoppe of Auras. Mail registration form to: The Little Shoppe of Auras 109 E. Bethalto Drive Bethalto, IL 62010

If you have any questions please contact us at [email protected] or call 618 377 9055. Store hours: Tues-Sat 12-7 / Closed Sunday and Monday