Fill in the registration form below by cutting and pasting into an email, choose your payment method, and email to: info"at" mickeltherapy.co.nz.
Please fill out one form per attendee and return with payment.
Once your registration form is received, you will be sent further details, directions, what to bring etc.
I look forward to sharing these wonderful tools with you!
Name .................................................
Phone ................................................ Cell ....................................................
Email ...................................................................
Address ..........................................................................................................................
I am registering for the following seminar:
Title of Seminar ............................................................... Date of Seminar ...........................
Date of Registration .........................................
Price (Earlybird or Regular - see workshop details page) ................................
Note: Full payment must be received by the earlybird deadline to receive the discounted price.
I AM PAYING BY CHEQUE / CREDIT CARD / ONLINE BANKING (Circle one or delete inapplicable)
TOTAL AMOUNT PAYABLE:..............................................
CHEQUES: Please make cheque out to HEALING GRACE
ONLINE BANKING: Please email Kim for bank account details: info “at” mickeltherapy.co.nz
Please put YOUR NAME as the reference and send an email to info “at” mickeltherapy.co.nz to advise when payment has been made.
CREDIT CARD: PLEASE NOTE 8% administration surcharge for credit card payments
I (Name) ………………………………….……. authorize Healing Grace Natural Therapies to debit my credit
card NZ$ ………………......
Name on card ………………………………………………………... Expiry Date ……………………………..
Card Number ………………………………………………………….............. Signature …………………………………………….
Please fill in the relevant sections of the above form and either:
a) cut and paste into an email and email to info "at" mickeltherapy.co.nz
b) cut and paste into a word document and post to: 34 Red Hills Road, Massey 0614, Auckland
If you are paying by cheque, please enclose cheque with your registration form and post to 34 Red Hills Road, Massey 0614, Auckland.
If you are paying online, please pay and send an email to advise payment has been made and cut and paste the registration form details into an email and email to info "at" mickeltherapy.co.nz
If you are paying by credit card, please supply your card number, name on card and expiry date by phone or email, and cut and paste the registration form details into an email and email to info "at" mickeltherapy.co.nz
See below for booking and cancellation policy.
Mickel Therapy Clinic Health Seminars Registration Page - back to top