Registration Form
Please cut and paste form into an email and send to sjberman@me.com or mail
with your deposit to 2615 Cone Ave. Durham, NC 27704
Name:
Address:
Phone:
Email:
Date of Birth:
Tuition: $350.
There is a $50 (non-refundable) deposit.
Your deposit will be refunded if class is cancelled due to weather or unforeseen circumstances arise.
Send to: Sarajo Berman. 2615 Cone Ave., Durham, NC 27704
BRIEFLY ANSWER THE FOLLOWING QUESTIONS. Use an additional sheet of paper (as needed) to answer the questions below:
1. What kind of health care services do you offer your clients? Number of years?
2. What draws you to participate in this workshop?
3. Do you have a practice that brings you into silence, stillness, out of doing and/or that quiets your mind? What is that practice?
4. How do you nurture yourself?
5. What brings beauty into your life?
6. What makes you feel good ?
Suggested viewing prior to class:
Youtube
Embryology – The Midline – Carol Agneessens
Michael Kern - Biodynamics
Do you want to receive CEU credits? Please Print your name as you want it on your certificate.
Thank You and I look forward to working with you. sarajo
Address:
Phone:
Email:
Date of Birth:
Tuition: $350.
There is a $50 (non-refundable) deposit.
Your deposit will be refunded if class is cancelled due to weather or unforeseen circumstances arise.
Send to: Sarajo Berman. 2615 Cone Ave., Durham, NC 27704
BRIEFLY ANSWER THE FOLLOWING QUESTIONS. Use an additional sheet of paper (as needed) to answer the questions below:
1. What kind of health care services do you offer your clients? Number of years?
2. What draws you to participate in this workshop?
3. Do you have a practice that brings you into silence, stillness, out of doing and/or that quiets your mind? What is that practice?
4. How do you nurture yourself?
5. What brings beauty into your life?
6. What makes you feel good ?
Suggested viewing prior to class:
Youtube
Embryology – The Midline – Carol Agneessens
Michael Kern - Biodynamics
Do you want to receive CEU credits? Please Print your name as you want it on your certificate.
Thank You and I look forward to working with you. sarajo
