Student Registration & Consent Form
Contact Information
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Email *
Name *
Certificate Name: what name would you like to show on your Certificate? *
Email Address *
Shipping Address *
Phone Number *
Gender
Date of Birth
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Which Dates are you interested attending for the Training? *
How did you hear about us? *
Required
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...
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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: *
Required
*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: gyoharmony@gmail.com  
 *
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
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