Name *

First Name

Last Name

Phone *

(###)

###

####

Preferred method of contact: *

Email

Phone

Workshop Enrollment *

Which workshop are you enrolling in?

Vancouver - Pubic Bone (August 8-10)

Vancouver - C1/Neck (October 10-12)

Victoria - Pubic Bone (September 26-28)

Victoria - C1/Neck (October 24-26)

Are you enrolling for personal use, professional development, or both?

Personal

Professional

Both

Health & Consent

Do you have any physical conditions or injuries we should know about before hands-on practice?

No

Yes

Consent to Participate in Hands-On Learning: *

I understand that this course includes hands-on work and I give my consent to participate.

Cancellation Policy *

I have read and understand the terms of the cancellation policy.