Registration Form -

The registration form for the course "Kashmir Ritual Massage" from the 18th until the 21st of May 2018 at The Mirror Centre in Amsterdam. Click the "Submit" button below to send the form after filling in all the questions. You will soon receive a registration confirmation mail with further details for the payment of the deposit. All the information you share with us is confidential and for the facilitator only.
www.houseoftantra.org
Email address *
Naam
*
Your answer
Email address *
Your answer
Age *
Your answer
Gender *
Do you have experience with tantric massage? *
If yes, please elaborate.
Your answer
Phone number *
Your answer
Are you a professional massage therapist? *
Your answer
What is your motivation to participate in this course? development of my being. *
Your answer
Have you experienced psychiatric episodes in the past? *
if so, describe them
Your answer
How do you know about this workshop? Internet *
Your answer
A vegetarian lunch buffet is offered for 12,50 euro per day extra. Would you like to join? *
(You can change your mind until one week prior to the workshop, just send us an email)
Questions & comments:
Your answer
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