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Name *
Address
City/Town
Phone
Email *
Current occupation and/or previous training (eg, midwife, hypnotherapist etc)
Course Option ');document.writeln(' ');document.writeln('
Course Location * ');document.writeln(' ');document.writeln('
Payment instructions will appear when you have sent this form
Terms & Conditions
A $150 deposit is required with this form to secure your place. Payment of the final balance is due 3 weeks prior to the course commencing. We reserve the right to alter dates and venues.
In the event that you cannot attend this course no refund will normally be given.
You may however be entitled to attend a future course. Should a refund be granted an administrative fee of $75 will be deducted in addition to the cost of any materials received by the enrollee.
By submitting this form I confirm my understanding and acceptance of the Terms & Conditions.
Please type the code shown in the image: *
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