INTEGRATIVE TOUCH SEMINARS-EARLY REGISTRATION FORM

If you would like to register for a class
PLEASE COPY THIS INTO AN EMAIL/PRINT. SEND OR FAX OR CALL INTO US AT 941-726-2345  email: info@integrativetouch.net FAX 941-330-9921

Name:  ______________________________    Massage license# _____________
Email: _______________________________
Address:  ____________________________ Telephone #:___________________
                ____________________________            Cell #: ___________________
Check the following course you are registering for.

Integrative Pregnancy Massage- 20 CEUS:  $350/$375
___Sarasota, Fri, Sat & Sunday TBA  9-5:30
___TBA

Pediatric and Infant Massage- 7 CEUS:  $100/$110
___ Sarasota,TBA 9-5

Oriental Bodywork Shiatsu-Level 1- 16 CEUS:  $265/$250
___Sarasota, TBA

Advanced Techniques of Oriental Bodywork: Gua Sha and Cupping- 8 CEUS:  $110-$175 with cupping set and liniments-(optional) Bring yours to class if you have them
___ Sarasota, TBA

**Registration is non-refundable once paid.  Transfers are granted upon arrangements.
Mail registration form and check payable to (Integrative Touch Seminars) To:
830 Central Ave
Sarasota, FL 34236                          OR FAX: 941-330-9921 or call to give credit card info
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If paying by Credit Card and sending Registration, Please fill out the following information completely or indicate a call be made to take info over the phone.
Be sure to include the information that corresponds to the credit card you are using.

____ Visa     _____ MasterCard     _____ American Express   _____ Discover

Card #________________________________ Exp:  _______ Security Code: ________

Name as it appears on the card:  _____________________________________________

Address:  _____________________________

City:  ___________________State:  ________

Zip code:  _____________
Home Telephone #: (_____) ________-_________ Email:  _______________________
I authorize  _______ to be charged to my card by Integrative Touch Seminars & Therapies for services rendered on  __________

Upon receipt of registration you will be sent a confirmation with directions to the seminar and a list of items to bring. Thank you and I look forward to meeting you!