Registration Form
April 12-14, 2024 // Gainesville, FL
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 inspires you for take this training course?
What is your optimal wish 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 )
Full course tuition
$350 + processing fee
$
360.00
Non-Refundable Deposit
$150 + processing fee
$
155.00
Tuition Balance
$200 + processing fee
$
205.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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