Open Heart Levels 1 & 2 Workshops Registration
Event Timing: January 26th-27th, 2019
Event Address: 9212 Vendome Drive, Bethesda, MD 20817
Contact us at (=1)240-381-9322-7890 or
First and Last Name
Date of Birth
Phone Number *
What days will you attend? *
Day 1: Open Heart Level 1 – First Timer (Fee: $100)
Day 1: Open Heart Level 1 – Repeater (Fee $25)
Day 2: Open Heart Level 2 – First Timer (Fee: $150)
Day 1: Open Heart Level 2 – Repeater (Fee $25)
Deposit required to hold your space. Please proceed to send deposit as follows:
By Check (Please send deposit check to Martha L. Atkinson, 9212 Vendome Drive, Bethesda, MD)
By PayPal (Please send $52.00 deposit to
A copy of your responses will be emailed to the address you provided.
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