Ashi-Thai Registration

Ashi-Thai Date you are Registering for*

First Name*

Last Name*

Your Name as you would like it to appear on Certificates/Diplomas. Please include any designations (RMT,CMT,LMT...)*

Phone Number*

Email Address*

I prefer to be contacted by*
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Mailing Address for certificate/diploma*

City*

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Zip Code

Height (In Feet/Inches)*

Weight (In pounds)*

Have you taken any Ashiatsu workshops with us before?
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Deposit
This class is accredited for 16 NCBTMB CE hours. We pride ourselves in holding small intimate seminars. A deposit is required to reserve a spot in our small (8) person workshops.
Your $200 deposit is non refundable should you cancel out of your selected workshop when scheduled workshop takes place. A (1) time courtesy roll over will be allowed in the case of health emergency with prior notice. We will refund 100% of the deposit for any canceled seminar is due to our responsibility. When buying airfare, we suggest using Southwest airlines when ever possible as they do no have a penalty for changing reservations.

Please Send check or money orders to:

Symmetry Therapeutic Massage Spa
2416 W 32nd Ave
Denver, Colorado 80211

Tuition*
Deposit ($200)
Full Tuition - Ashi-Thai ($399)

Payment Method*
Mail CheckCredit Card (PayPal)
Mail Money OrderCredit Card (Phone)

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