Workshop Registration Form
Please complete this Caribbean School of Holistic Therapies Health and Wellness (CSHTHW) workshop registration form and SUBMIT to complete registration.
Email address *
Caribbean School of Holistic Therapies (CSHT)
Which workshop are you taking? *
Where are you located? *
Selected workshop start date *
Your answer
Title: Mr • Mrs • Ms • Miss *
Your answer
First Name: *
Your answer
Last Name: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
National ID # (ID, DP or Passport): *
Your answer
Your Current Address: *
Your answer
Primary Telephone Number: *
Your answer
Present Occupation: *
Your answer
Qualification (if any)
Your answer
Emergency Telephone Contact: *
Your answer
Are you able to give / receive treatments in a mixed setting of males / females? *
Required
Please indicate any special (i.e. language) needs that CSHT should be aware of:
Your answer
Please indicate any disabilities or medical conditions that CSHT should be aware of (including allergies):
Your answer
NOTE:
In the event that we do not meet the minimum number of participants courses may be rescheduled. In the event the course does not commence at all, a full refund will be given.

CARIBBEAN SCHOOL OF HOLISTIC THERAPIES
Ascot House
Ascot Avenue
Gibbs, St. Peter
Tel: (246) 833 4754 / 823 1003
Email: schoolofholistictherapies@gmail.com
FB: @cshthw

“Your entire universe is in your mind and nowhere else. To expand the universe, expand your mind.” Deepak Chopra
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