Student Registration & Consent Form
Contact Information
Sign in to Google to save your progress. Learn more
Email *
Name *
Certificate Name: what name would you like to show on your Certificate? *
Email Address *
Shipping Address *
Phone Number *
Date of Birth
Which Dates are you interested attending for the Training? *
How did you hear about us? *
Occupation *
Do you have a pacemaker? *
Do you have any metal in your body? If Yes, Where it is located in your Body? *
Are you on any medication? If yes, please explain. *
Are you pregnant? If Yes, how far along? *
Do you have any Medical condition that the Facilitator should know about? *
Do you have sensitivity to essential oils? If yes, please explain? *
Are you familiar with Energy healing, Reiki or Sound healing? *
Using your Sound Healing training are you looking to work with...
Clear selection
Do you have any physical pain at the moment? If yes, please explain. Where in the body, level of pain (0-10), for how long have you been feeling this discomfort? *
Are you experiencing any of the following (check all that apply)
Emergency Contact *
Phone number *
Is there anything else that the Facilitator should know about you attending this training?
Is this training for Personal education or Professional enhancement? *
Giving consent to use Photos or Videos taken from the facilitator for the use on Social media and for marketing purposes. *
Preparing for the Training please read the following webpage Information: *
*Registration fee with Manual: $50 (non refundable) 
Payment: Cash (in person), Check , Venmo @GyoHarmony 

*Send a Check to: GyoHarmony 
PO Box 8281 Truckee CA 96162

$50 to save your Spot. Email me:  
Do you need an Invoice for your Training? 
*If Yes, to which email address should I send it to?
Payment Options: Before clicking on the following options Please Venmo (@Gyoharmony), Send Check, or Cash (In person) the desired amount for the Training FEE:                                            
*Full price including registration fee: $550  ($50 non refundable & $500 refundable 7 days prior the workshop)  
*Half price including registration fee: $275 ($50 non refundable & $225 refundable 7 days prior the workshop)
GyoHarmony ~ Sound and Healing Arts ~ Gyongyi Ridenour ~ (530)562-5400
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy