Simple Tools®  REGISTRATION FORM

Instructions:

1)  To register, please complete this form and press the Submit button. 

2)  Pre-registration guarantees your space at the lecture.

3)  Pre-pay by mailing a check and save $5 (sorry, on-line payment is not available).  Otherwise, payment is by cash or check at the door the evening of the lecture.  Make checks payable to Karen Strange, and mail to Big Belly Services, 5307 S. Alaska Street, Seattle, WA  98118.

 

Number of Registrants:

Registrants' Names (please list all):

Your mailing address:

(street)

  (city, state, zip)

Your email address:

Your phone numbers:

home

work

cell

other

Where did you hear about this lecture?

Are you a parent, birth professional, therapist, other?  Please specify below:

PAYMENT OPTIONS:

1. Pre-pay by mailing a check and take $5 off the regular workshop fee.  

2. Pay at the door.  Checks or cash are accepted at the door for the regular workshop fee.   No Credit Cards please.   

3. Sorry, on-line payment is not available for this event.  

 

 

To prevent automatic form submissions:

please enter the number you see in the picture below here:

 

 

You must click here to submit your registration form: