Holotropic Breathwork with Elizabeth Hess Stamper and Ted Riskin

Registration Form

Name _____________________________________________________

Address ___________________________________________________

City _________________________   State _____    Zip _____________

Phone (day) [______]________________ Phone (evening) [______]_______________

Email address  __|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__

Please register me for   ___ May 6  ___ May 7

Tuition enclosed $____________ 

Either day: $65 if received by May 1, $75 after  

Both days: $120 if received by May 1, $135 after

Cancellations received one week in advance are refundable.
After this a $20 processing fee will be applied.

We will contact you and/or send a confirmation letter with directions
and other pertinent information prior to the workshop. 

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