Registration Form

Group Consultation Registration Form

The full group consultation amount is due with registration unless other arrangements have been made.
Please complete the registration form and submit with your check payable to Janine Sousa to: Healing Touch 45 Princeton Street #3 N. Chelmsford, MA 01863
Please print
Name___________________________________________________________________

Address_________________________________________________________________

________________________________________________________________________

Telephone #__________________________e-mail _______________________________

Group Consultation_________________________________________________________

Date of Group Consultation__________________________________________________

Amount enclosed ________________Check # ________________Date:_______________

Cancellation Policy:
Time Frame Policy Up to one week before the group consultation A refund will be issued for the amount paid less a $25 processing fee. One week to 48 hours before the group consultation A credit for another group consultation or service will be issued for the amount paid less a $25 processing fee. Less than 48 hours before the group consultation No refund or credit will be issued.
I have read and agree to the cancellation policy.

________________________________________________________________________

Time Frame	Policy
Up to one week before the group consultation	A refund will be issued for the amount paid less a $25 processing fee.
One week to 48 hours before the group consultation	A credit for another group consultation or service will be issued for the amount paid less a $25 processing fee.
Less than 48 hours before the group consultation	No refund or credit will be issued.