Lomi Lomi Advanced Training Course

Lomi Lomi
Advanced
Training

Registration Form • Harbin Hotsprings Lomi Lomi Advanced Training

Harbin Hotsprings
Advanced Practice Reunion • October 5-9, 2012
Earn 32 NCBTMB Continuing Education Hours
THIS FORM IS FOR PRINT / FAX OR MAIL ONLY

Name (as you'd like it on your certificate): ___________________________________________________________________
Address: ___________________________________________________________
City: _________________________________________ State: ________________
Zip: ____________________ Phone(s): ___________________________________
Email: _____________________________________________________________
For Credit Cards: _____ Visa ____ MC ____ Discover ____Amex
Cardholder's Name: _________________________________________________
Card #: ___________________________________ Exp. Date: ___________
Signature: ___________________________________________
If credit card billing address differs from the above address, please include your billing address here
_________________________________________________________________
_____ Yes, I have a massage table I'm willing to bring.
Amount Enclosed
DOLPHIN I'm coming to Harbin for the first time _______ $1250	NAVIGATOR I've been to Harbin before _______ $1150	KUMU I've Apprenticed or am on the 'Teacher Track' with Sacred Lomi _______ $1050
I will arrive on the 5th (add $42) _______ I will stay an extra day on the 9th (add $42) _______
Amount Enclosed: $__________ full amount / _________ $200 deposit
______ I will pay the remaining balance by mail or by calling in at a later date ______ Please charge the remaining balance on this date: _______________________
Checks should be payable to Sacred Lomi, LLC

Space is limited. Registration is on a first come, first serve basis. To guarantee your space, send $200 non-refundable deposit.
Sacred Lomi
PO Box 1206, Agoura Hills, CA 91376-1206 • Phone & Fax: (818) 865-8813
Workshop Location
Best Western Fairfax

We will send a welcome packet with a list of what to bring and a receipt two weeks before the class.
For specific questions about the class, please contact Tom or Donna at:
Sacred Lomi
(818) 865-8813 • www.SacredLomi.com

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Lomi Lomi Advanced Training

Registration Form • Harbin Hotsprings Lomi Lomi Advanced Training

Harbin Hotsprings Advanced Practice Reunion • October 5-9, 2012 Earn 32 NCBTMB Continuing Education Hours THIS FORM IS FOR PRINT / FAX OR MAIL ONLY

Lomi Lomi
Advanced
Training

Harbin Hotsprings
Advanced Practice Reunion • October 5-9, 2012
Earn 32 NCBTMB Continuing Education Hours
THIS FORM IS FOR PRINT / FAX OR MAIL ONLY