Tilopa Tai Chi Qigong Center, Minneapolis, St. Paul, Minnesota, and Maui, Hawaii

Registration Form
Tai Chi and Qigong
Maui, Hawaii
Marilyn Allysum
808-879-5776

Name: __________________________________________________

Address: ________________________________________________

City: _____________________________ State: _________ ZIP: __________

Home Phone: __________________ Work Phone: _____________________

Email: _______________________________ Cell: _____________________

Qigong CLASSES:
Payment: $ ________

Tai Chi and qIgong class:
Payment: $ ________

weekend retreats:
Payment: $ ________

Our MAUI TAI CHI & QIGONG RETREAT :
Payment: $ ________

Payments are due in full prior to arrival.
We do not pro-rate.

PLEASE SELECT YOU TRAINING SESSION PREFERENCE AND SIGN BELOW

Signature ______________________________________________________

FEE INDICATED IS PER PERSON COST
Payments accepted by cashiers check, personal check, PayPal.com (a division of eBay)

- I'm PayPal Verified