Registration Form


Print the following form and fill in blanks

Your Name:

Phone Number:

Address:

City/State/Zip Code:

Name Of Workshop:

Date of Workshop:

Please mail your registration information with a check for $25.00 to

Workshop size is limited, so send your registration at least seven (7) days prior to the workshop.

Make your check payable to Conscious Bodywork Associates.

Copyright © 2023 Jim Lovestar All Rights Reserved.