Peter Hess Sound Massage Seminar Registration

Peter Hess ® Sound Massage Seminar Registration

Peter Hess Academy, USA

Thank you for your interest in learning with us!

Complete this form to secure registration for Sound Massage

seminars, and discuss any questions or concerns directly.

Contact Information

Participant Name: ______

Phone Number(s): ______

Email: ______

Mailing Address: ______

______

List any previous training in Peter Hess methods, & attach certificate copies:

______

For which seminar(s) are you registering today? Check all that apply...

___ Peter Hess ® Sound Massage Level I

___ Peter Hess ® Sound Massage Level II

___ Peter Hess ® Sound Massage Level III

___ Peter Hess ® Sound Massage Level IV

Starting Date: July 10, 2015 ending on 3pm July 17th, 2015

Instructor Name or City/State: Gina Armstrong ~ 808 Panther Ave, Sheboygan, WI 53081

Registration and payment

- In order to reserve your space, complete and submit this registration form, and pay a Deposit of $500 with the Balance due by June 1, 2015 for the Intensive price of $1500.00. (After June 1st the amount is $1800) Check that your entries are legible, complete, and accurate - if we cannot reach you, we cannot hold your space in the seminar.

- Along with electronic confirmation, you will receive an emailed invoice for the seminar costs, including payment due dates. If you did not receive an invoice, request another copy.

- Participation in the seminar without completion of both form and payment is not permitted.

Cancellation

- Up to four weeks prior to the start date, we will return 50% of the class fee.

- Less than four weeks prior to the seminar date the class fee is non-refundable.

- If the seminar is cancelled by Peter Hess Academy USA or the host/venue (for instance low attendance, or illness of the facilitator) we will refund your deposit in full.

- Peter Hess Academy USA and your facilitator are in no way responsible for the return of any other costs resulting from such a cancellation (i.e., hotel, travel, rental, etc.).

Responsibility

- Each participant takes full responsibility for themselves and their behavior both in and outside of the group, and must pay for any damages caused.

- No healing work takes place in our seminars. Peter Hess (r) Sound Massage is a supportive modality, and we do not diagnose, prevent, treat, or cure disease.

- Participants undertake to discuss any physical conditions or psychiatric disorders which may represent a risk to themselves or other participants with a physician or therapist, and to inform the seminar facilitator(s) of said conditions or disorders prior to the start of the seminar (see cancelation policy).

- The training cannot be commenced during the first three months of pregnancy.

- The seminar facilitator(s) can exclude participants from participation in the seminar at any time if their further participation would represent a risk to themselves, other participants or the seminar facilitator(s). In such a case, no funds will be returned.

Accommodations and Meals

- Meals at Peter Hess Academy Midwest (Manitowoc WI) are on own. There are multiple eating establishments available within walking distance. Meals (Lunch and a late afternoon snack) at Peter Hess Academy (Sheboygan, WI) will be catered and the participants are obligated to take meals onsite, which will involve additional costs not to exceed $20 per day or $140 total.

Certification

- Attendance certificates are provided for Levels I, II, III, & IV. The certificate holder is not yet authorized to professionally practice Peter Hess ® Sound Massage (see below)

- Practitioner Certification is dependent on successful completion of additional requirements (Please speak with Gina individually on this since this may not apply for 2014 and 2015):

- Candidates must provide written proof of having received three (3) training sound massage sessions freely chosen from the list of authorized providers.

- Candidates must be present for 100% of the supervision weekend seminar; after successful completion of Peter Hess ® Sound Massage Levels III/IV, or the Intensive Seminar (Levels I, II, III, & IV together).

Participant Signature: ______

Date: ______

Submit via:

Scan: /

Mail: Gina L Armstrong 924 Buffalo Street, Mantowoc, WI 54220