STAR Tech Healing and Learning Center
Training Workshops for Massage Therapists and Bodyworkers
  
Advanced Training Registration
Download and print this form to register for a Professional Training STAR Tech® Workshop.
Mail the completed Registration Form with full payment or with a deposit.

Workshop(s) I plan to take

 Date Cost
  STAR Treatments for Upper Body - Arms, Lateral Shoulders   Sept. 25. 2010  
  STAR Treatments for Upper Body - Neck & Medial Shoulders   Sept. 26, 2010  
  Active Stretching for EveryBODY - Self-Stretching   Nov. 14, 2010  

  *Please Double Check for Possible Discounts     

    

   Deposit     

   $

   Balance Due Day of Workshop    

   $

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

Name: _____________________________________________________________

Address: ___________________________________________________________

Telephone: Home: _________________ Work: ___________________

E mail:  ___________________________________________________
I am a
 ____ Massage Therapist; ____ Physical Therapist; ____ Chiropractor;
 ____ Fitness Trainer; ____ Coach; ____ Student; ____ Other
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:____________________

Certification of Completion
 ____ I do want, ___ I do not want a Certificate of Completion for the Workshop(s) I am attending.
On my Certificate of Completion, please show my name as:

___________________________________________________________ (please print clearly or type)

I learned of these Workshops from: ___ Newspaper, ___ Magazine, ___Poster, ___ Internet,

____ e-mail,____ Brochure, ___ Friend or Co-worker, ___ Previous Workshop,

___ Other – Please Name the Source ________________________________

                                                                                                                                        Revised 8-17-10

Training Workshops