Registration Form

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Register & Pay for Workshops

Please complete and submit the registration form below first, then choose the workshop you are registering for in the PayPal form to either pay deposit or full workshop fee. You will be taken to the PayPal site to complete your transaction. Thank you!

Your Name (required)

Your Email (required)

License # - State or National (if you have one)

Organization

Street Address Line 1

Street Address Line 2

City

State

Zip Code

Country

Cell Phone

Home Phone

How did you hear about me?

Registering For:
Reiki Level IReiki Level IIReiki Level IIITop Ten Pain ReleasersTouch for Health Level 1Reflexology WorkshopChildren’s Nature Camp

If registering for a class, please specify dates and location:

If registering for children's camp, please specify age of child:

Please send more information about:
AccommodationsDirectionsCourse ContentCE CreditsCost

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