Healing through Creativity Workshops Registration

Contact Information

Required Fields are marked in red text

Salutation:
First (Personal) Name:
Middle Name:
Last (Family) Name:
Full Name on Badge:
Title/Occupation:
Email Address:
Re-Enter Email Address:
Phone:
Fax:
Mailing Address Line 1:
Mailing Address Line 2:
City:
State/Province/District:
Postal Code:
Country:

Workshop Selection

Click on the name of the workshop to select.

Enter group discount code:

Emergency Contact

Please let us know who to contact in the event of an emergency. Please include:

  • Name of emergency contact person
  • Relationship to yourself
  • Daytime and evening phone numbers and email address(es)

Payment Method

 Credit Card (Visa, Mastercard, American Express)

Cancellation Policy: Registration and payment is online by credit card only. No exceptions! There will be a $50 USD fee assessed for charge backs issued on valid credit card charges. Registration payments must be received by the registration deadline for the rate at which you registered; if payment is not received by the deadline, you will be responsible for the higher rate. Winter/Spring 2015 Workshops - cancellations and refunds are valid until Friday, March 6, 2015 minus a 10% handling fee. No refunds are possible after Friday, March 6, 2015, however your workshop fee may be applied to a future workshop anywhere in the U.S., Canada or Europe.
 
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