Please select which class you plan to attend. Please select which class you plan to attend. March 26 & 27, 2021 - Animal Reiki Master Class online May 22, 2021 - Animal Reiki I & II Class online

First Name

Last Name

Email Address

Address

City

State

Zip Code

Cell Phone Number

Home Phone Number

Precise Name on Certificate -Middle Name? Initial? (No designations please)

Please tell us a bit about your past Reiki experience(s), and/or how you plan to use what you learn from this class:

Pre-requisite - I have taken a Reiki II or Reiki I/II class prior to this class. I understand that this is a pre-requisite for taking this Animal Reiki class. Pre-requisite - I have taken a Reiki II or Reiki I/II class prior to this class. I understand that this is a pre-requisite for taking this Animal Reiki class. Yes

I am taking the Animal Reiki Class and I am... I am taking the Animal Reiki Class and I am... 18 years-old or older. 16-17 years old and will be accompanied by a paying parent or guardian.

I understand that my deposit is non-refundable but may be applied to a future class within 12 months. I understand that my deposit is non-refundable but may be applied to a future class within 12 months. Yes

I understand that my certificate will be awarded upon completion of the class and full payment has been received. I understand that my certificate will be awarded upon completion of the class and full payment has been received. Yes

I acknowledge that I may receive periodic emails from Teresa Jantz/Touchpoint Therapy before and after our class. I acknowledge that I may receive periodic emails from Teresa Jantz/Touchpoint Therapy before and after our class. Yes

I opt-in to receive Touchpoint Therapy newsletters. You can always unsubscribe at anytime. I opt-in to receive Touchpoint Therapy newsletters. You can always unsubscribe at anytime. Yes No, not at this time

How did you hear about this class? Please choose all that apply. How did you hear about this class? Please choose all that apply. Internet search for Reiki Internet search for Teresa Jantz Touchpoint Therapy website Reiki Share Facebook Instagram Reiki . org Reiki News Magazine Word of Mouth Advertisement Email from Teresa Jantz/Touchpoint Therapy Teresa Jantz Other (Please explain in message box directly below)

Any extra message (Optional)