EmailMeForm
Okuden & Equine Reiki:Advanced Techniques
Mirrambeena, Bucca Wauka, Mid North Coast, NSW
Please complete the following enrolment form in full. Once complete, please review the Cancellation and Refund Policy (provided separately), sign the bottom of this form, and press SUBMIT.
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Email
*
Phone
*
Please provide a brief outline of
your experience with horses
*
Please provide a brief outline of your experience
with holistic therapies?
*
What is your current occupation?
*
Please list any known allergies or physical disabilities?
*
Do you suffer from depression, anxiety attacks, PTSD or any other form of mental illness?
*
COURSE DATE OPTIONS
Please select from the drop down menu below which course date you'd like to enrol in
Okuden & Equine Reiki: Advanced Techniques at Mirrambeena, Mid North Coast, NSW
*
Please select
May 22nd - 25th 2023
October 16th - 19th 2023
November 27th - 30th 2023
PAYMENT OPTIONS
Option 1 - Full Payment $1195AUD
Please select
$995 - full payment
Your spot on the course is confirmed once full payment is received
Option 2 - Payment Plan - Deposit $295
Please select
Payment Plan - Deposit of $295 payable on enrolment
A deposit of $295.00 is payable on enrolment, then equal payments due every 30 days with final payment due 2 weeks before course commencement
Option 3 - Resitting Fees - $200
Please select
Resitters fee - $200
This is a reduced payment for students of Four Winds Reiki only. If you have previously completed Okuden & Equine Reiki: Advanced Techniques with Four Winds Reiki, you need only pay this minimal fee to resit.
Payment Options
*
Direct Deposit
Paypal
An invoice with payment details will be sent to you via email once your enrolment has been processed.
Please check any that apply
*
I am vegan
I am vegetarian
I am pescatarian
I am gluten intolerant
I don't eat seafood
I am allergic to nuts
I am allergic to bee stings
I am lactose intolerant
None of the above
In Case of Emergency Contact
Please provide the name and contact number of a person you'd like us to contact in case of emergency.
Name
First
Last
Phone
###
-
###
-
####
Declaration:
I hereby declare that I am applying for the above named course. I have read the course outline and agree to pay all fees by the due date and understand that fees may *not be refundable in the event I need to cancel, and that fees are to be paid in full 14 days before commencement of the course.
Refund:
In the event Four Winds Reiki cancels my course for any reason I will be offered a place on any other scheduled course (of my choosing) or I may elect to receive a refund in full of all monies paid by me at the time of cancellation.
*
I agree
I have read the Cancellation and Refund Policy
A copy of the Refund and Cancellation Policy can be found at https://www.healingjourneyswithhorses.com/cancellation-and-refund-policy/
I would like to receive information and updates, please add me to your mail list
Signed
*
Date
*
Insert Code Here