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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.
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Seattle, Washington
Saturday, September 12, 2015 - 9:30 AM to 5:00 PM
Sunday, September 13, 2015 - 8:45 AM to 4:15 PM
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Registration:
Before August 12, 2015 $245.00
After August 12, 2015 $265.00
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| REGISTRATION FORM |
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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 _____________________________
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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
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