The Fascial Human.Eng

1. Registration data for The Fascial Human dissection course with Julian Baker on 25th-29th June 2018 in Katowice, Poland.

This data is collected only for registration and contact with participants. It is protected according to the law and will not be given to any third party.

Name and Surname
Adress (street)
City
Zip code:
Country
E-mail
Mobile phone

* 2. I will register in the workshop using:

I am aware of need of payment of deposit (1000 PLN or 250 Euro) or whole fee to be placed on the list.

PLN: 7000

Euro: 1650

* 3. I want my invoice to be issued for:

A private person

A company

4. If you choose invoice for company, please provide company details:

Name, adress, tax number.

* 5. I am:

Physiotherapist

Osteopath

Physician

Massage therapist

Movement practitioner

Other

(please specify)

* 6. Name and surname (signature)

I confirm I know and accept the rules and conditions of participation in The Fascial Human dissection workshop on 25th-29th June 2018 in Katowice, aviable on www.handson.pl

* 7. Date:

Ankieta

Zarejestruj bezpłatne konto w 15 sekund i twórz własne projekty ankiet, testów i formularzy online - za darmo! .