Registration – “Nurturing the Nurses” Retreat – 2016 May 17, 2016 | Events, Nurturing the Nurses - 2016 Retreat Retreat is open to ALL nurses. August 26 – 28, 2016 – Westerbeke Ranch, Sonoma, CA Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* RETREAT FEE Includes 2 nights lodging; retreat; organic meals: Fri. dinner – Sun. lunch. All rooms at Westerbeke are shared. If you need a single room, please make your own offsite lodging arrangements and register as a Commuter, below. Commuter fee includes retreat; organic meals: Fri. dinner – Sun. lunch.Retreat Fee* $200/Deposit on 3-4 person room, balance due by Aug. 8, 2016 $495/3-4 person room, if received by 8/8 $545/3-4 person room, after 8/8 $200/Deposit on 2-person room, balance due by Aug. 8, 2016 $575/2-person room, if received by 8/8 $625/2-person room, after 8/8 $200/Deposit for Commuter, balance due by 8/8 $395/Commuter, if received by 8/8 $445/Commuter, after 8/8 OPTIONAL - CONTINUING EDUCATION (CEs) FOR NURSES Healing Journeys is approved by the California Board of Registered Nursing, Provider No. CEP 10808. Other Boards may accept this approval. Please check with your individual licensing Board.CEs $25/Retreat (12 CE credits). Fill in license info below. No CEs, thank you License # Kind of License If you'd like to share a room with specific people, please give us their name(s) below:Preferred Roommates: Please let us know below if you have any special dietary needs or any other needs we may be able to accommodate.Dietary needs: Special needs (disabilites; other): CANCELLATION POLICY If cancellation is received by August 1: refund less a 15% administrative fee. If cancellation is received from August 2 – August 18: refund less a 50% fee. No refunds after August 18. Fill out the section below to provide your credit card information for the amount authorized by selections that have a cost that you made above. We accept Visa, MasterCard, Discover, and American Express.Total Amount $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name More Information: Big Day of Giving – May 2, 2019 Details – “Nurturing the Nurses” Retreat – 2016 Faculty – “Nurturing the Nurses” Retreat – 2016 Overview – “Nurturing the Nurses” Retreat – 2016
