Name:
Address:
City:
State/Province:
Postal Code/Zipcode:
Country:
Email:
Phone:
Gender:
Emergency Contact:
Emergency Contact Phone:
How many hours of training with
Other past trainings with certified trainers:
For our reference,
Dietary Considerations:
Please note: The facility provides healthy, mostly
vegetarian fare. If you have specific dietary requirements,
please bring what you need.
Tuition:
$1100 ($900, if registered by June 1)
Cancellation Policy:
If we cancel the training because of too few participants, you will receive a full refund. July 9 , your fees will be refunded (minus $100 USD processing fee).July 10, you will forfeit your deposit of $250.
Any Questions?
For further information contact:email
Completing Your Registration:
Payment Information:
Please mail deposit of $250 when you submit this form. For the discounted tuition price of $900, your deposit must be RECEIVED by June 1st. balance by July 2nd. Train For Life Communication, and mail to: Registration is only finalized
I agree with the terms and conditions of this training event.
Print this form?
We suggest printing a copy of this form for your records before submitting.