Gift Certificate Request Form

Healing Palms of Kauai uses the term "Sponsor" to describe the person or group of individuals purchasing a retreat and/or vacation package as a gift. We recognize the effort it takes to make this very special purchase. We request that one contact name be given as the primary coordinator of this gift, however all individuals will be recognized on the accompanied Gift Certificate.

Healing Palms of Kauai will work with the primary coordinator or the participant directly to coordinate this much-needed getaway. Gift certificates are available for specific programs, however a general "Care Package" gift may be purchased for the participant or caregiver to determine which one best fits his or her needs. You are purchasing a nurturing and supportive vacation specially tailored to the needs of your loved-one. We will make this a beautiful, re-energizing experience.

To submit this information to Healing Palms of Kauai via E-mail, press the Submit button at the bottom of the form.

Sponsor/Coordinator Information

Sponsor/Coordinator
Address
City
State
Zip
Phone Number
Alternate Phone Number
E-mail
Please list the individual names of your group sponsorship if applicable. (This is how they will be presented on the Gift Certificate.)
Is there any special situation we need to be aware of?
What program are you most interested in?
What month would work best?

Participant/Caregiver Information

Participant's Name
Participant's Address
City
State
Zip
Participant's Phone Number
Alternate Phone Number
Participant's E-mail

Healing Palms of Kauai will do everything it can to make this retreat/vacation a beautiful, re-energizing experience. We schedule our programs months in advance. If you have special needs or circumstances, please feel free to share them with us. Your comments and feedback make a difference.

Payment Terms

Healing Palms of Kauai requires payment in full for gift certificate purchases. Gift Certificates expire within one year from the purchase date. Healing Palms of Kauai reserves the right to make extensions on a case-by-case basis.

Payments are accepted in Cash / Traveler's Checks, Personal / Certified Check, Money Order, Visa or Mastercard.

Direct Mail to:
Healing Palms of Kauai, Inc.
P.O. Box 9172 Denver, CO 80209
Attention: Accounts Receivable

In the event of a cancellation, we require 60 days' advance written notice. This can be done via e-mail. We are sensitive to our caregivers needs and understand that life circumstances can limit one's participation. We request your consideration by giving us as much notice as possible. With 60 days' advance written notice, your full deposit shall be placed into a special account for future guaranteed use of your vacation in whatever program you desire. If you require a refund, we will assess each individual situation. The amount refunded to you will depend upon the amount of notice given, our expenses incurred to hold your accommodations, etc., and/or the ease of filling your cancelled reservation.

Ultimately, Healing Palms of Kauai would like to accommodate the special needs of the participants. We will do whatever we can to facilitate a win-win situation.

Mahalo Nui Loa (Thank You Very Much)!