body revitalizations
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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