meditation classes registration form

Mindfulness of Emotions Series 2017

Name:______________________________________ Phone: ( )_________________________


E-mail: _____________________________________________ Date:_____________________

Workshop and Classes: ____$80 or  ___$70 (AYS member rate)     Workshop only:  ____$50

To register: Please sign & mail this registration form to Dori at:
4612 So. Schafer Branch Rd, Spokane, WA 99206 with a check payable to Dori Langevin
or a copy of your PayPal receipt. If you prefer to use Pay Pal please add $3 to the price (e.g. $83, $73, $53).

Refunds will be made if Dori is notified by phone by September 24. No refunds after September 24

By registering,  I understand and accept the payment and refund policy.

____________________________________________________________  ______________
Signature                                                                                                           Date