Program Registration

Awakening to the Call of Somatic Intelligence

Module 1 – October 20-22, 2017
Module 2 – November 10-12, 2017
Module 3 – December 8-10, 2017
( 9:30 to 5:30 each day)

Vienna, VA

Registration - Awakening to the Call of Somatic Intelligence 2017

Contact Information

Full Name *

Email Address *

Phone Number *

Waiver

Please review and sign the following waiver:

Any and all aspects of the course are undertaken voluntarily on your part. The course is not meant as therapy or as a replacement for any other professional service that you would engage for your physical or mental health. The waiver is your acknowledgement that the Personal Transformation and Courage Institute is released from any liability related to your participation in the course. The undersigned knowingly releases and holds harmless the Personal Transformation and Courage Institute and its agents from any and all claims, suits, proceedings, costs, losses, expenses, damages, and liabilities, including but not limited to attorney’s fees and court costs, caused by and arising out of, or in connection with his/her participating in this course.

E-Signature *

Payment

Tuition for this course is $1,800.

Refund Policy: Cancellations that are made one week prior to the starting date of the course are eligible for a refund. After that date, a refund is available if we are able to fill your spot with another course participant. A waiting list will be maintained for those who are interested if no registration spots are available. Refunds will be issued in the same form as original payment.

Total: $1,800

Payment Plan

Please check this box if you will be making multiple payments for this course.

Payment Type

Please indicate how you will be paying for this course:

PayPal / Credit Card

Check

Initial Payment

To pay via PayPal account or credit card select this option and then click the "REGISTER" button below and complete the payment process on PayPal's secure website. Select the "Pay with Debit or Credit Card" option on the first page to use your card and proceed without creating a PayPal account.

Please make your check payable to the Personal Transformation and Courage Institute.
Please use check's memo line to indicate which course you are paying for.

Mail check to:
PTCI
P.O.Box 914
Virginia Beach, VA 23451