Reg Form MIA | osteopathic-wellness

Registration Form

Matter In The Atom: The Anatomy and Physics of Sound Healing

First Name

Last Name

Mailing Address

City

Region/State/Province

Postal / Zip code

Phone Number

Pleae indicate your status as one of the following:

Physician

Resident

Student

Retired Physician

Degree/level of training and license number for physicians OR the name of residency program or university if you indicated your status as such above.

I HAVE READ AND AGREE TO THE FOLLOWING TERMS AND CONDITIONS: *Cancellation Policy: Full refund allowed before February 9, 2024 minus a 15% processing fee; 50% refund allowed after February 9, 2024. No refunds after April 12, 2024 *No external or personal audio or video recording, photographing, sharing or reproducing any part of this class and video is permitted. *NO REPRODUCING IN ANY WAY OF ANY PART OF THIS CLASS AND VIDEO IS PERMITTED UNLESS PERMISION IS OBTAINED IN WRITING. *It is the responsibility of ALL participants to use the information provided within the scope of their professional license. By submittmg this form, I agree to the terms & conditions.

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Matter in the Atom Class Regular Rate - $875.00

Matter in the Atom Class Resident/Retiree/Student Regular Rate - $775.00

Thanks for registering!You will receive course updates and materials via email as the time gets closer!