'Getting The Love You Want' Registration Form

Your Name (please make this the name of the person paying for the workshop below).*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Enter Email Confirm Email

Your partner's name*

First Last

Your Partner's email

Enter Email Confirm Email

Your partner's phone number

How did you find out about this workshop?*

Which workshop date do you want to sign up to?*

Conditions for registration*

Please tick the box below to indicate you fully agree to abide by these conditions.

Cancellation policy. A registration fee of £100 per couple is non-refundable. For cancellation up to one week prior to workshop, the balance of payment will be refunded. For cancellations less than one week before the workshop date no refunds will be given but attendance can be deferred to a later date with payment of £100.

How would you like to pay for the workshop?*

Please sign us up for one couple's place on the "Getting The Love You Want" workshop*

Price: £ 595.00

Total

£ 0.00

Bank Transfer details Please pay the full amountto Dr. S. Slade Sort code : 51 50 00 Account number 64038815

For enquiries contact Bryan Greene at Bryan99greene@gmail.com or phone 01275 395215

Sophie Slade