PLEASE NOTE:  There are no Healing the Inner Child Workshops currently scheduled for Northern California, so the form below will not submit.  For updates, please check back periodically on the schedule page or contact Anne.

The Healing the Inner Child workshop is limited to 8 participants in order for each person to experience maximized, in-depth attention.

To register, please fill out the form below and submit; you will be directed to another page with payment information.  You may also use the form to make an installment payment for the workshop if you have already enrolled; please select the installment payment option on the form if this is the case (you may pay any amount up to the remaining balance that you owe for the workshop, and in any number of installments that you would like).  If your address is in a country other than the U.S., please enter your postal code in the Zip field, and if you have no state or province enter "None" in the State field.

The workshop price is $350.00 per person.  You may reserve your spot with a deposit of 125.00 (or more), or with a full payment if you prefer; the first $125.00 is non-refundable.  Please select the option corresponding to your choice.

Please also select the payment method option that you would like to use: check, credit card or PayPal.  The payment instructions that you will see after submitting the form will give you further information on how to proceed with each method.

If you would like to make a payment for more than one person but want to make one payment transaction for all of them, please fill out the form once for each individual that you are paying for.  After each form submission, you will be given the option to return to this page to complete the form again for another person.  When you have submitted the form for each person that you wish to include, you may then proceed to follow the payment instructions.

 
Name *
Street Address 1 *
Street Address 2
City * State *
Zip *
Home Phone * Country *
Work Phone Gender * Male Female
Cell Phone
E-mail Address: *
Please select workshop dates *
Payment * Deposit     Full payment     Installment
Enter the payment amount for
this enrollee
*
Payment method * Check      Credit card     PayPal     Other
How many people will you enroll
in this payment transaction?
*
How did you hear about this
workshop?
Additional Comments
 
* Required


Return to the Healing the Inner Child workshop page.

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