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REGISTRATION FORM PLAY THERAPY SEMINAR

Printable form
Please note which seminar you would like to attend.
As space is limited, please register early
 
Seminars:  
Workshop Title:
  (required)
Dates:
Name: (required)
Address:
City:
Prov./State:
Postal/Zip Code:
Country:
Phone:
Work Phone:
Fax:
E-mail: (required)
Occupation:
Education/Play Therapy Experience:
In this box
type: @  (required)		  
Anti-Spam Box: please type a single:  @
Have you taken a seminar with me before? If so what seminar have you taken?
What are some of the issues and goals you would like to address in the seminar that you have registered for?
Would you like to book individual consultation/personal/professional development time after the seminar? On what day? How many hours?
PLEASE NOTE: A $100.00 deposit is required at the time of registration. The remaining amount is due one month prior to the seminar. Please make your cheque or money order payable to Marie-José Dhaese, and send it in by mail.

CANCELLATION POLICY: Cancellation must be received by telephone and in writing one month prior to the date of the seminar or the whole amount will be forfeited. Before that date, your $100.00 deposit will be held for administrative fees.
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Click the Submit button and don't forget to mail in your deposit.



Note: if you do not receive a reply in one day,
please phone (250) 335-1829.

If you would like to mail in your registration please click HERE for a printable form.