Changing bodies, Changing Lives

Easy Print Booking Form

Complete the form on your PC, then print out and sign.
Make your cheque payable to Elizabeth R. Perkins, and send to:
11 Exton Road, Sherwood, Nottingham, NG5 1HA

Name of Course

Dates

from 

to 

Cost of Weekend

First name

Last name

Address

Telephone
(including code)

Day 

Evening 

Fax 

Email 

Do you have any physical difficulties of which we should be aware?
(please give details)

Are you vegetarian?

(please tick box if so)

Other dietary needs (please give details)

Where did you hear about this weekend?

What are you hoping to get out of it?

This form is for weekend workshops only. To book for a day workshop, see the information here.

Payment

I enclose £50 deposit (non-returnable) to secure my place. I understand that the balance will be due 4 weeks in advance of the course and at that stage will be non- refundable.

OR

I enclose full payment of £

I understand that , if I have to withdraw from the course:

* up to 28 days before the start date, £50 will be retained

* after this date, the whole course fee will be retained.
Signature: ...........................................................................