SACRED BODY WORKSHOPS
WITH Brian & Claudia Scrivener
REGISTRATION FORM
Please copy this form and return it with payment by mail to
8209 Aberdeen Rd., Coldstream, BC Canada V1B 2L9
Or, copy this page and attach it to a message to sacredbody@shaw.ca
WORKSHOP TITLE:__________________________________________________
DATES: _______________________
LOCATION:_______________________________
FEE: ________
FOR MORE DETAILS SEE www.sacredbody.net
CALL 250-550-7326 OR 7325 or E-MAIL sacredbody@shaw.ca
Name:______________________________________________
Address:________________________________________________________________________________
_______________________________________________________________________________________
Postal Code: ______________________
Phone No. (w)_______________________(h)________________________
(cel)____________________
E-mail:________________________________
Method of payment: Cheque made out to Scrivener Communications (enclosed) ___
Credit card: Visa ___ Mastercard ___
Account No. __________________________________ Expiry Date ________/_____
Amount: _____________
Signature________________________________________