v-Touch Massage Registration Form

Registration Form
Course: Introduction to the VTouch Method
Course Dates: September 15 & 16, 2010 - Ft. Lauderdale, FL

All Information Must Be Completed for CE Units at the Completion of the Course

Participant's Name
Today's Date
Address
City, State, Zip
Work Phone #	Mobile Phone # Home Phone #
Email Address
Massage License #	SSN#
Payment Method	Credit Card Number Exp. Date (mm/yy)
CV Code Required (back of card)
	Total Amount to be Charged: $490.00 ($415.00 when registered by 7/15/2010 or if a current Massage School Student.) Cancellation & Refund Policy—There are no cancellations or refunds, however with 30 days advanced notice in writing, the tuition may be deferred to a subsequent VTouch Method Course. The VTouch Method and VTouch Massage is an Approved Provider for Continuing Education Credit by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).
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Vincent Monforte developed the V·Touch Method™... an extraordinary, intuitive, healing process.

954.303.7069

Vincent Monforte, LMT MA#51626

Swedish - Therapeutic - Deep Tissue - Sports/Medical - Reiki - Myofascial Techniques - Reflexology