Empire Method Course Registration
Posture class April 11th 2026 and/or Extremity class April 12th 2026
What in-person classes are you registering for:
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Empire Method Intro (Sat April 11th at 8am-10am 2026) Cost = Free
Postural Class (Sat April 11th 8am-5pm) Cost = $400 (includes access to online videos)
Extremity Class (Sun April 12th 8am-5pm) cost = $400 (includes access to online videos)
Student Information
Student Name
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First Name
Last Name
Specialty: OT,PT,ST, Lactation, other
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Phone Number
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Format: (000) 000-0000.
Email Address
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I understand that I am to bring $400 in cash or check to Empire Method if I am attending more than just the 2hr free intro.
Both classes together are $800
Date Signed
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Month
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Day
Year
Date
Print Form
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