Enrollment
Enrollment Form
Please use this form to enroll for a course.
We contact you very swiftly to confirm your enrollment.
For any question, do not hesitate to contact us, by email, or direct call (phone, whatsapp, skype)
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I would like to enroll for the following course(s) :
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This activity takes place in the month of :
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Your given name
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Your name
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Your email address
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Your phone number
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Your date of birth (optionnal)
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Personal details (required)
Other informations (optionnal)
Your place of birth (optionnal)
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Your qualification
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Your profession
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Your energetic experiences
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What is your motivation to enroll
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Medical and nutritive information (optionnal
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Remarks or questions :
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I read and agree the enrollment conditions
Thank you to confirm my enrollment. Please send me the practical information and the information for the payement.
Thanks to accept these two conditions
Pour vous inscrire via un smartphone, merci de nous envoyer un email via e bouton ci-dessous ou de consulter cette page via un ordinateur pour accéder au formulaire d'inscription.
Merci

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Center for Body Therapies
