Application Form

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APPLICATION FORM

 

Western Canadian Association of Jungian Analysts

“Essential Jung: A Weekend Retreat”

September 27-29, 2024

Village Creek Country Inn, Pigeon Lake, AB

 

 

First Name____________ Last Name___________________

Address: ___________________________

City_______________ Province__________

Email Address________________________

Phone number _____________(Home) _______________(Cell)


Registration

Fee: Early Bird Registration Deadline: August 01, 2024. $350.00

Late Registration: August 01- September 13, 2024 $425.00

Any registration after September 13 will be considered on an individual basis.

Full-time Students and Seniors 65 and over will receive 10% off the registration fee.


Cancellation Policy:

Cancellation of registration before September 01, 2024 – 50% of the deposit will be refunded.

There will be no refund for cancellations after this date.


Food Preferences:

There will be a set menu for lunch and dinner catered for the retreat. You may have breakfast as part of the meal plan or on your own. Please check off the following:

Meat/Poultry ________ Vegetarian. _________ Other __________ (please specify)

Food allergies. ______________________________________________________

Breakfast as part of the weekend menu: _____Yes. ______No

(There are a couple of small cafes in the village that may serve breakfast items. See Village activities at villagecreekcountryinn.com)

Cost of meals/person for the weekend: With breakfast $125.00 plus taxes

Without breakfast $95.00 plus taxes

Note that the meals are NOT part of the retreat fee but each registrant will pay for their meals to the Village Creek Country Inn upon leaving.


Accommodation:

Accommodation at the Inn provides a variety of options including single or double rooms, with or without a fireplace, or a triple room. For more information and to book your accommodation go to villagecreekcountryinn.com or call them at 1-780-586-0006. Please inform them that you are part of the WCAJA weekend retreat.


Payment Method:

Payment of the registration fee may be made by sending the application form and payment to Dan Cross, the Registrar. Payment can be made by e-transfer to dancross@crossmagill.com OR by sending a cheque made out to WCAJA along with the application form to:

Dan Cross
101, 10411 122 Street NW
Edmonton, AB T5N 4C2

 

Your registration will be confirmed as soon as possible once payment is received.

Note: The accommodation and meal costs must be paid directly to the Village Creek Country Inn before you leave. They are not part of the registration fee.

If you have any questions about the weekend, please email Mae Stolte at mmstolte2@gmail.com.

Thank you for your registration. We look forward to meeting with you!