Embodyment Awareness Training

REGISTRATION FORM

Please register for this program by printing out & completing a copy of this form.

Name __________________________________________________

Address ________________________________________________

Phone ___________________________

Certificates will be awarded to those completing all four modules & all assignments.

Check off the method of payment you prefer

	Option 1. Early Bird Discount:
	Option 2. Four payments:

Amount enclosed ________________

Cancellation Policy

Cancellations which occur 60 days or more prior to the starting date of the program are fully refundable less $250. For cancellations which occur from 59 to 14 days prior to the starting date, 50% of the training fee is non-refundable. No refunds are possible 14 days prior to the starting date, unless you recruit a qualified person to take your place.

I am signing up for Embodyment Awareness Training.
I am committing to all four modules of the program.
I have read your cancellation and certification policies and accept the terms.

Signed _____________________________ Date ________________

Please make out your cheque/money order to Ann Ohlmacher & mail with the completed form to:

ANN OHLMACHER
613-795-4836
annyrose@embodyment.org