IHR Course Registration Form:

Please provide the following information & read the information below before sending your form:

Name of course: (Shinpiden, Shinpiden re-sitting and/or Student Intensive)

Date of Workshop: (all classes are from 10am - 6pm)

Your First & Last Name:

Address:

City

State

Zip Code

Country

Email Address:

Home Phone:

Work Phone:

How you heard about the class ( International House Of Reiki website, referred by other practitioner, flyer, IHR newsletter, books by Bronwen & Frans, other (please let us know):

Current Reiki Level (Check one):

Reiki II

Reiki Master

Reiki Master/Teacher

***Please read below information before sending form!!!!

You will receive a confirmation email from Janet Dobbs that she has received your information form and confirmation that you are registered in the class once your payment is received.

Please make your payment as soon as possible to secure your place in the course as there are limited places. You are not registered until you make your deposit. You can either pay in full or make a 50% payment to secure your place. If paying 50% please pay the remaining balance 10 days prior to the course date. (March 26, 2010)

You can make your payment via Paypal or send a check made out to:

Janet Dobbs

11907 Paradise Lane

Oak Hill, VA 20171-1519

Refund policy:

Refunds are only given if a course is altered or cancelled by the International House of Reiki. We do not accept responsibility for changes in students’ personal circumstances and reserve the right to alter/cancel any of the available courses. Once you have booked a course you are committed to the course and if you cannot attend you will have to find a suitable replacement as you are liable for the full amount of the course.

Please check the below box before sending your form.

By checking here you are acknowledging that you have read and agree to the above refund policy. Checking this box is the same as your holographic signature.

Inclement weather Policy:

If the workshop has to be postponed due to inclement weather, the workshop will be rescheduled to a future date and you will either be able to attend that workshop or a workshop of your choice in a different area.

Privacy is important to me; therefore, I will not sell, rent, or give your name or address to anyone except Frans & Bronwen, ever.