Shamanism, Dying & Beyond
An Advanced Weekend Workshop with Beth Beurkens, M.A.

REQUIRED WORKSHOP FORMS

Whether you are paying your tuition with Pay Pal, Check or Money Order,
you must fill out this two part registration form and mail it to:


Beth Beurkens, M.A. • P.O. Box 483 • Ashland, OR 97520

Along with your payment, this will complete your registration for the workshop. Thank You.

Seattle, Washington
Saturday, September 12, 2015 - 9:30 AM to 5:00 PM
Sunday, September 13, 2015 - 8:45 AM to 4:15 PM

Registration:
Before
August 12, 2015   $245.00
After
August 12, 2015      $265.00


REGISTRATION FORM
 

Name ____________________________________________ Phone __________________________

Address (include city, state and zip code)

_________________________________________________________________

_________________________________________________________________

Email ________________________________________________

Where did you hear about this course?

_________________________________________________________________________________

Approximately, When, and with Whom did you take the Foundation for Shamanic Studies -
Way of the Shaman course? (Prerequisite for any advanced FSS course)?


_________________________________________________________________________________

LIABILITY RELEASE FORM

Date _____________________________

I will not hold Beth Beurkens, Beth Beurkens Seminars, Catherine Valentine, The Foundation for Shamanic Studies, or the Sunset Hill Community Association responsible for any injury, illness, accident or other misfortune that may occur in connection with my participation in the Dying and Beyond workshop at the Sunset Hill Community Association in Seattle, Washington on September 12 & 13, 2015.


Signature ____________________________________________________________

Printed Name ____________________________________________________________

PLEASE PRINT AND SEND VIA US MAIL. DO NOT EMAIL
Please include a registration form and liability waiver for each individual.

Beth Beurkens, M.A., P.O. 483, Ashland, OR 97520
[email protected]   www.shamanicuniverse.com