Clone of Reiki Registration Form

Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Mobile Number*

Format: (000) 000-0000.

What are your current challenges in life right now?

What emotional, mental or spiritual challenges do you currently have regarding your own health?

What do you think and/or feel needs to happen now in your life?

What do you believe is your soul's purpose?

Please list any medications you are currently taking and why:

Have you studied / practiced Somato-Respiratory Integration before?

YesNo

How do you wish your name to appear on your Certificate?

PLEASE SELECT the workshop you wish to attend. Upon receipt of your payment, you will be notified via email of any homework you need to do in preparation for this workshop:

SRI (Somato Respiratory Integration): April 25-26, 2026, 9:30-6:30 pm

This 2 day training (9:30 am to 6:30 pm EST) is a combination of lecture, discussion, demonstration and practice time. In this 2 day workshop, you will learn techniques and strategies that will help facilitate your own healing and transformation. This will instantly help you release the mental, emotional, physical and spiritual blockages that prevent you from moving forward in your life so that you can experience your body more fully. Handouts and a Certificate of Completion will be provided.

$575.00

SRI (Somato Respiratory Integration): June 6-7, 2026, 9:30-6:30 pm

This 2 day training (9:30 am to 6:30 pm EST) is a combination of lecture, discussion, demonstration and practice time. In this 2 day workshop, you will learn techniques and strategies that will help facilitate your own healing and transformation. This will instantly help you release the mental, emotional, physical and spiritual blockages that prevent you from moving forward in your life so that you can experience your body more fully. Handouts and a Certificate of Completion will be provided.

$575.00

Total

$0.00

Credit Card

I authorize Oasis Health & Wellness to charge my credit as noted above:

Oasis Health & Wellness Center

90 Dale Avenue, #1402, Scarborough, Ontario, M1J 3N4

Cell: 647-571-5477 * Email: grace.so.oasis@gmail.com

SRI Registration Form

Credit Card