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Laughter Yoga Leadership Training - Registration Form

LYLT Booking, Step One - Complete Registration Form

YES I'd like to secure my booking for the Vibrance Laughter Yoga Leadership Training with Australian Laughter Yoga Teacher, Laughter Ambassador and Mindbody Specialist Kathy Popplewell!

E-mail Address: *

First Name *

Last Name *

Address *

Suburb *

State *

Postcode *

Country *

Date of Birth (dd/mm/yyyy) *

Gender *

Mobile Phone

Home Phone

Work Phone

Occupation

Company

Payment Method *

Cash via Bank Transfer
Credit Card via Paypal
Credit Card over the phone

If you have a PROMO CODE enter here

Please book me in for *

Sydney, January 2012
Melbourne, March 2012

How did you find out about us? *

If OTHER please describe

I understand that cancellations within 14 days of the workshop incur a $50 fee and that cancellations within 5 days are non-refundable. *

* Required

If you have any problems submitting your registration form please try a second time and if it still does not process contact Kathy on 0405 147 154 directly to register over the phone.