2017 Camp Registration Form

West Coast Acutonics

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Home
About
- Practitioners
- What is Acutonics?
Certification Classes
Forums
Classes with Laurie Herron
Free Classes & Resources
Acutonics Camp
Register & Shop
Contact
Blog
Classes

Register for Acutonics Camp

Please fill out the registration form below. You will then be directed to the payment page.

Acutonics Camp 2017 Registration

* Indicates required field

Name *

First

Last

Cell Phone *

Home Phone *

Work/Office Phone *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

How many levels of Acutoncis training have you completed? *

Please check which level of Camp you would like to register for: *

Happy Camper - $85.00 / day Clinical Hours - $150.00 / day Elective - $500.00 for four days

How many days will you be attending Camp? *

I will be attending all 5 days! 1 Day 2 Days 3 Days 4 Days I'm registering for the Elective (4 days)

If you are only attending part of Camp, please let us know which days you will be attending: *

Will you be planning on camping on our land? ($45.00 flat rate) *

Yes - I want to camp No - I'll be finding other accomodations

Please check all of the areas that you are interested in: *

Deepening of Chinese medicine foundations Bodywork techniques with Acutonics Energy work Intuition enhancement Being observed as a practioner Time for questions about your own practice

Do you have any dietary retrictions? Please let us know! *

Is there anything else you would like to let us know? *

Submit

WEST COAST ACUTONICS
Laurie Herron and Katie Mink, L.Ac.
(510) 816-3731
[email protected]
Text is a great way to reach us!