Empowering Journey Registration form




	Courses
	- Empowering
	- Discovery
	- Adventure
	Lectures
	1-1 Coaching
	Corporate Training
	Events Calendar

Thank you for choosing to register for Empowering Journey.
Please fill out the Registration form below and press submit.
We will contact you by phone once we receive the form to confirm the details.

Fields marked with * are required.

First Name*:
Surname*:
E-Mail*:
Postal Address 1*:
Postal Address 2:
City*:
County:
Postal Code*:
Telephone*:
Mobile :
Date of Birth :

Please select the Course date you would like to register for from the drop down list:


Empowering Journey 3 day course £345



Previous self- development courses attended:


What would you like to get out of the course? (Optional):


Meal requirements : Please state if you require vegetarian food or have any other special requirements:




Payment:
A deposit of £50 is required at the time of registration. The balance will be required two weeks before the course begins. Please post your deposit to: 23 Beaumont Ave, St Albans, AL1 4TL Cheques should be made payable to: Peter King