Conflict Resolution Registration Form               

Please print this form and forward it along with your payment to:

7Centers Yoga Arts, 2115 Mountain Road, Sedona, AZ. 86336 or email to: yoga@7centers.com

Name:

Date of Birth:                                                          Sex:

Street Address, State & Zip Code:

Telephone:                                                Email:

*We will be sending you an orientation letter - let us know if you need it mailed to a particular address. Otherwise we will contact you by e-mail.

Credit Card #: (Visa/Mastercard) :                                                                                Exp. Date :

Signature code on the back of your card__________

(   ) Enclosed is the full amount of $450.00

(   )  If prior to June 21st - Early Registration in full is $400.00.

If you are paying by check please make it payable to Mystis, Inc., our non-profit organization.

 What do you hope to gain from this workshop?

Is this part of completing your 500 hour certification with 7 Centers?  _________