Life Life To The Max Seminars

Registration Form

Seminar Series consisting of three Saturday morning sessions:

January 2012

 

Saturday January 10th 2012  9am-1pm

Saturday January 21st 2012  9am-1pm

Saturday January 28th 2012  9am-1pm

 

Venue to be confirmed

Please complete the form below to register for the Personal Empowerment Seminar

EARLYBIRD OFFER until February 8th $185  - Normal Rate $225 

Once you have registered you will need to pay to secure your place.

Payment can be made via internet banking into the following account: 

Westpac 03 1599 0094254 000

Please enter your Name in the payee field and "Empower" in the reference field. 

If you have any questions about making payment or registration, please contact Karoline by email:
karolinegrant@freedomtherapies.co.nz

Note: If you would prefer to print and post your registration, you can download the form by clicking here.

 

Your First And Last Name (required)

Company

Date of Birth (required)

Gender (required)

Address (required)

Suburb (required)

City (required)

Postcode

Home Phone (required)

Mobile Phone

Your Email (required)

Optional Message / Questions: