Please fill out the registration form
Event Date: Saturday February 10, 2018 or Tuesday February 13, 2018
Recommended: Shamanism 101 or Journey experience
Event Address: 9 Crown Street Milford, CT 06460
Time: 9 am - 4 pm
Contact us at (203) 980-4103 or CGB@IntegrativeEnergyMedicine.com
Integrative Energy Medicine Institute Certification
Instructor: Chantal Guillou-Brennan, CHT, IEMT, Shamanic Practitioner.
First & Last Name to Appear on Your Certificate
Please register for one of these classes
Each class starts at 9 am and ends at about 4pm
Saturday February 10, 2018
Tuesday February 13, 2018
Do you have special requirements?
Difficulty focusing or Attention Deficit Disorder
Stressed in group settings
Some exposure to Shamanic Journey is helpful for this training but not mandatory
I have experienced Shamanic Journey before
What are you looking for in this class?
I understand that I will have to pay $175 upon arrival or pay $150 now
Payment: Cash, check or CC with 4% surcharge (use Paypal - "Not a service" or "friends & family" to avoid Paypal 4% fee.) Your payment is !00% refundable when you notify us of your withdrawal at least 12 hours before the class.
Yes, I prefer to pay $175 (+ 4% Square Up fee) at the door. This option does not guarantee you place in the class.
Pay $150 (+ $6 Paypal fee) 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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