Please fill out the registration from
Event Date: Sunday February 4, 2018 or Saturday April 28, 2018
Time: 9:00 am - 4:30 pm
Event Address: 9 Crown Street Milford, CT 06460
Contact us at (203) 980-4103 or CGB@IntegrativeEnergyMedicine.com
Integrative Energy Medicine Institute Certification
Instructor: Chantal Guillou-Brennan, Certified Reiki Master and Teacher
Are your Reiki 1 & 2 certification from the Integrative Energy Medicine Institute?
If not you will need to take a short review test to assess your knowledge. Upon evaluation you may need to come in a hour prior to class to review the missing material. The fee for this varies from a donation to $50. Attunements are not included in the review class. Please contact Chantal to request a copy of the review test, by clicking on the contact link on this site.
Please email me the review test now.
First & Last Name to Appear on Your Certificate
Choose your date
Sunday February 4, 2018
Saturday April 28, 2018
Do you have special requirements?
Difficulty focusing or Attention Deficit Disorder
Stressed in group settings
What are you looking for in this class?
I understand that I will have to pay $325 upon arrival or pay $300 now
Payment can be cash, check or CC with 4% Paypal fee (choose "not a service" or "friends & family" to avoid Paypal 4% fee.)
Yes, I prefer to pay $325 at the door.
Pay $300 now at:
This class was recommended to me by (their first and last name or leave blank)
Please add $10 toward their next training with the Integrative Energy Medicine Institute.
CONSENT AGREEMENT: READ & APPROVED
I have chosen to experience the above workshop of my own free will. I am aware that the process of studying/practicing healing modalities may bring up issues of a highly personal nature that may cause me to experience emotional or physical responses which may be unexpected and/or unpleasant. I understand that none of the healing modality taught are a substitute for medical care and I am advise to discuss my personal physical or mental issues with my physician. Additionally, I should continue any present medical treatment and consult my medical doctor for treatment of any illness. I confirm that I do not currently suffer from any mental or physical impairment, and have not been diagnosed in the past with any disorder, condition, or injury, either physical or mental, that might make it un-advisable for me to study the modality I am enrolling into.By signing this document below, I willingly agree to hold harmless and release from all liability the organizers, facilitators, and participants in this workshop, including Chantal Guillou-Brennan, IEMP, CHT, CQHHT and the Integrative Energy Medicine Institute. Read and approved:
I HAVE READ AND APPROVE THIS CONSENT AGREEMENT.
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