Online Registration

Date

First and Last Names

Street Address

City, State, Zip Code

E-mail address (for registration confirmation)

Day Phone (area code first)

Cell/Mobile Phone

In paying your $600.00 USD Circle of Stones registration fee [that includes a $100 non-refundable reservation fee] please select from the credit or debit cards listed below:

Visa

MasterCard

Discover

Credit or Debit Card Number

Expiration Date: Month/Year [mm/yy]

3-digit security code 🛈

Full name exactly as it appears on this credit/debit card

Select the dates of the Circle of Stones gathering you are attending:

Dates to be announced

Do you have any dietary restrictions or preferences (please be specific)?

What mode of transportation will you use to come to your Circle gathering?

NOTE: If you need to stay overnight on Sunday after the end of the Circle gathering, please notify KohlQuest immediately so we have enough time to make the needed arrangements. (828-288-0730 or email at support@kohlquest.com)

Protecting your personal information is a top priority at KohlQuest. All personal and financial data is protected by advanced SSL encryption. To assure safe, secure and accurate processing of every credit or debit card purchase, KohlQuest has selected PayPal for processing all online transactions. Your registration payment will appear on your statement as a transaction from PayPal KohlQuest.

IMPORTANT INFORMATION. PLEASE READ IT CAREFULLY.

By submitting this registration form, you agree to hold harmless KohlQuest, its employees, agents, freelancers, subscribers, students, or independent contractors against any and all liability, loss, or expense, including attorney fees, arising directly or indirectly from your participation in the Circle of Stones gathering. You further acknowledge that you hereby agree to forefeit and forgo ay right of claim or action whatsoever against KohlQuest, its employees, agents, freelancers, subscribers, students, or independent contractors for any reason arising from your participation in the Circle of Stones gathering.

Before submitting your registration form, be sure to print a copy for your records. Once your form and payment have been processsed, you will receive an email notification that your place in the Circle of your choice has been confirmed.

Once you have completed the above form and checked to be sure all your information is correct, CLICK ONLY ONCE on the SUBMIT button below.

All of us at KohlQuest look forward
to greeting you in the Circle of Stones!