Practitioner Training Registration Form

Embodied Traditions™ Holistic Abdominal Therapy Practitioner Training

with Michelle Hansen
Registration Form
Name

First NameLast Name
Email
example@example.com
Course Title
Course Dates
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Occupation
Website
Referred by / How did you hear about this course?
Pleases provide a brief bio about yourself
Please note: Registration does not guarantee a spot. A deposit is required to secure your place in the training.
Pay with Credit Card / Debit CardPay with VenmoPay with Apple Cash (iPhone Users)Pay by Check
Pay with Venmo

(you will see this logo)

@Michelle-Hansen-134
- Deposit $250
- Early Bird $1,500
- $1,250.00 if paying deposit separately
- Regular Rate $1,600
- $1,350.00 if paying deposit separately
What to Include:
- Your full name
- Class date
- Deposit / Early Bird / Regular Rate
Pay with Apple Cash
- Deposit $250
- Early Bird $1,500 ($1,250.00 if paying deposit separately)
- Regular Rate $1,600 ($1,350.00 if paying deposit separately)
How to pay with Apple Cash
- Make sure you have the amount needed in your Apple wallet.
- Open text messages.
- Enter my phone number 952–240–0132 (send me a text first so you know you're sending to the correct person!)
- Tap the + button (app drawer), then choose Apple Cash.
- Enter the amount, add a note and push send.
What to Include:
- Your full name
- Class date
- Deposit / Early Bird / Regular Rate
Pay by Check
- Deposit $250
- Early Bird $1,500
  $1,250.00 if paying deposit separately
- Regular Rate $1,600
  $1,350.00 if paying deposit separately
Make check payable to either:

Michelle Hansen or
Moon Shadow Healing Arts

Send check to:

Michelle Hansen
Moon Shadow Healing Arts
11000 West 78th Street #25
Eden Prairie, MN 55344

What to include:
- Your full name
- Class date
- Deposit / Early Bird / Regular Rate
Credit Card / Debit Card Payments:

You will see Moon Shadow Healing Arts on your credit card statement.

🔺 PLEASE READ BEFORE MAKING A CREDIT CARD / DEBIT CARD PAYMENT
- Select Course Deposit + Early Bird Price (if Early Bird pricing is still available)
- If Early Bird pricing has ended, select Course Deposit + Standard Price

🔺🔺🔺 Please read the message above before making your payment 🔺🔺🔺

Course Deposit

Holds your spot, balance due later

$250.00 Quantity

Early Bird Price

Payment must be completed no later than 4 weeks before the in-person training begins.

$1,250.00 Quantity

Standard Price

Payment must be completed no later than 1 week before the in-person training begins.

$1,350.00 Quantity

Total

$0.00

Credit Card

Should be Empty:

Embodied Traditions™ Holistic Abdominal Therapy Practitioner Training

Registration Form

Credit Card