Workshop Registration

Registration Form

Fill out the form carefully for registration. You will be contacted within 48 hours to confirm your spot in the workshop!
Client Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address*
example@example.com
Mobile Number*
Which workshop(s) do you plan to attend?*

Navigating the Holidays after LossNavigating the Holidays after Divorce (women only)
Is there anything you would like us to know prior to this event?*
NOTICE:

1. Payment is due at the start of each event. By signing below, you agree to pay in full upon arrival OR you agree to contact the front desk if accommodations must be made prior to group beginning. (Each workshop is $65).

2. Cancellation Policy: all appointments must be canceled 24 hours prior to the beginning of the session. Your signature below also serves as acknowledgement of our cancelation policy.
Your Signature*

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Registration Form