Registration Form
September 18-21, 2025
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Where are you from or currently living?
What is your occupation?
What is your optimal wish and inspiration for taking this course?
Are you a Licensed Massage Therpaist:
Yes
No
If you are a LMT, please provide your license number.
Signature
*
Payment
My Products
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( X )
Course Tuition
$
415.00
Deposit
Reserve your spot // Non-refundable
$
120.00
Tuition Balance
$
295.00
Weekend Tuition
$
300.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: