Clear Intentions Course Booking Form

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Clear Intentions Holistic Training Solutions Ltd - Booking Form

I wish to book onto the following Course/Workshop:

Course Title:

Course/Commencement Date:

1. Contact details:
Full Name:
Address:
Telephone/Mobile:
Email:
Date of Birth:
Do you have any disabilities or conditions which may require any special help during the course/workshop:
How did you hear about the course/workshop:

2. Declaration:
I confirm that I have read and understood and am happy to accept the Booking Terms and Conditions (available by clicking here).
Signed:
Print name:
Date:

3. Method of payment:
Cheque PayPal Credit/Debit Card (all major cards accepted)

Please state amount due: £ (full amount)

If paying by Cheque:
Please print off this form and send it, together with you cheque to: Clear Intentions Holistic Training Solutions Ltd, Hildon Villa, Pooley Lane, Moreton, Nr Newport, Shropshire TF10 9DU. Cheques should be made payable to Clear Intentions Holistic Training Solutions Ltd.

If paying by PayPal:
Please print this form before clicking on the PayPal button below to make your payment (for PayPal payment instructions click here). Please note that a payment made via PayPal also forms acceptance of the Booking Terms and Conditions (available by clicking here).

PayPal Transaction ID:

Once we receive your completed and signed Booking Form
we will send you a confirmation/induction pack.