REGISTRATION FORM

NAME____________________________________DATE_________________
ADDRESS_______________________________________________________

HOME PHONE__________________________________________________

WORK PHONE__________________________________________________

CELL PHONE___________________________________________________

EMAIL ADDRESS _______________________________________________

INDICATE WHICH CLASS YOU ARE SIGNING UP FOR:  
INTRODUCTION TO REIKI;  REIKI I;  REIKI II;  REIKI ART/MASTER  
DATE(S)______________________

Have you had any previous Reiki training? __________________

Have you had any Reiki treatments?  _______________

Deposit amount is $50.00 for Reiki I, Reiki II, Reiki ART/MASTER
Balance is due at registration the day of class.

Please complete this form and mail with your deposit made payable to:

Teresa George
268 E. Marina Pkwy.
Lorain, OH  44052


NOTE:  For Reiki I, II, ART & Master Classes, please dress comfortably
and bring a notebook or pad of paper, ink pen, pillow and blanket and a bag
or box lunch.  A fee of $25.00 will be charged for bounced checks.