STAR Tech Healing and Learning Center
Public Workshops for Pain Management and Improved Wellness
 Public Workshop Registration Form
Download and print this form to register for a Public Workshop.
Mail the completed Registration Form to arrive by the Pre-Registration Date,
with full payment for the Workshop(s) you plan to attend.

 Workshop(s) I plan to attend

 Cost

  Date Cost
 Touching the Angelic Realm

$40

  January 24, 2011
 Angel Readings for Beginners

canceled

  February 7, 2011
 Explore Your Akashic Records

canceled

  March 28, 2011


*Please Double Check for Possible Discounts                

  Deposit  $
  Workshop Total

        

 $

Please make check payable to: Barry L. Bailey
Mail to: STAR Tech Healing and Learning Center, 14 Nason Street, Suite 202, Maynard, MA 01754
 

Your Name: ___________________________________________________________(please print clearly or type)

Address: _______________________________________________________________________________

Telephone: Home: ____________________ Work: ____________________ Email: __________________

For Physical Workshops:  I certify that I am in good health and there is no reason that I can not engage in a full gentle Stretching /Exercise/Yoga program.
Signature: _____________________________________________________Date:____________________

        Certificate of Completion for Professionals taking these Workshops for CEUs:

____ I do want, ____ I do not want a Certificate of Completion for the Workshop(s) I am attending.

Please show my name as:________________________________________________________ (please print clearly or type)

I learned of these Workshops from: ___ Newspaper, ___ Magazine, ___Poster, ___ Internet,
___ e-mail, ___ Friend, Family or Co-worker, ___ Previous Workshop, ____ Sign on street,

 ___ Other – Please Name the Source  _____________________

                                                                                                                                Revised 1-25-11
 Public Workshops