Classes

Shamballa Basic Registration Form
Rays of Healing Light
 Print out this page and return it with your deposit

Yes, I want to register for the following workshop (please check box & enter dates).

£  Shamballa Basic Healer ($275) on _________________(Dates)
£  Shamballa Basic Teacher ($425) on _________________(Dates)
I enclose a deposit of $100 [non-refundable] for each workshop I have checked.

PLEASE PRINT in upper case letters:
Name ___________________________________
Address _________________________________
________________________________________
________________________________________
Telephone  (_____) ______- _______________
Email _____________________________________

MAIL THIS FORM
with DEPOSIT
made out to:

Nedda Wittels
9 Knollwood Circle
Simsbury, CT  06070

Personal Contract and Medical Consent Form
PLEASE PRINT

Personal contract and medical consent form for (your name) ___________________________________

I, ___________________________________ ,  do now invoke my I Am Presence to help me to prepare for this workshop, and to guide me during and after it.  I align my will with that of my I Am Presence.  

In case of emergency, you may contact the following person/s, and any relevant medical personnel:

     Name: ______________________________________ at (Phone) ___________________________________

I have the following medical conditions/allergies/whatever ________________________________________
_________________________________________________________________________________________

Signed __________________________________________  Date ________________________

DO NOT WRITE 
IN THIS SPACE

   Foundation ID _______________   Certificate ID _______________

                                                    F ______   A ______   Q ______

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