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Booking form - Kinesiology courses & workshops

name (print) _________________________________________________

address _____________________________________________________

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____________________________________________________________

tel: home______________________mobile________________________

e-mail _______________________________________________________

Previous kinesiology training (if any): course, year, number of days

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Booking details:

1. Fees payable to M. la Tourelle.
2. Early bird discount if payment is received 30 days before start date.
3. Cancellation: Full fee will be refunded if booking is cancelled at least 30 days before the start date but not after that date unless the course dates are changed.

signed ______________________________________ date__________________________

Integrated Practitioner Training, 70a Caversham Road, London NW5 2DS