Registration Form

Acutonics Class - Registration Form

DSCF0767 Judit2__0012 DSCF0764

This completed form, along with payment, is required prior to attending class.

Forks and other supplies may be purchased prior to class
and will be available when you arrive
or upon successful completion of your class.*

*Please note some Fork Sets are only available upon related class certification.
Please see detailed Class Information for specific course materials.
_______________

*First Name

*Last Name

*Street Adddress

*City

*State

*Zip Code

*Area code

*Phone Number

*Email Address

*Course Name

*Course Date

*Earth Moon Forks Set

*Solar Seventh Fork Set

Health Concerns?
Are there any Health Concerns we need to be aware of?

Personal Info
Pleae tell us a bit about yourself

AgreementJudith Sound Healing, reserves the right to dismiss a student from the course, without refund of tuition, should the student demonstrate unsatisfactory conduct. By registering for this class, I am agreeing to abide by the Judith Sound Healing's classroom requirements to behave in a professional and ethical manner, and to respect the privacy, dignity and sensitivity of everyone in the class. I also acknowledge that this work is deeply transformational and that being present and mindful of the energetics of the group is the responsibility of everyone participating in this class. I certify that I am in generally good health and am capable of participating in the Acutonics Training Course, and that the information I have given is true and factual.

*I Agree
If you agree to these terms Click Here

*Enter Security Code

*Required

Healing and Renewal through Sound Therapy