Canadian School of Colon Hydrotherapy A Career in Colon Therapy Registration Form Applicant Name:* First Last Address Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Date of Birth Date Format: MM slash DD slash YYYY Cell PhoneHome PhoneEmail In Case of Emergency - Contact Name & PhoneIndicate Choice of Programs & Deposit Paid5-Day INTENSIVE Program - Colon Hydrotherapy Certification Course$2900 Course Fee$500 Deposit4-Day INTENSIVE Program - Colon Hydrotherapy Certification Course$2400 Course Fee$500 Deposit1-Day Business ProgramAvailable as a stand-alone program for all Colon Hydrotherapy practitioners (new or existing) and/or people considering opening their own business.$650 Course Fee2-Day Skill UpgradeDesigned to teach therapists the benefits of the latest technology.$1200 Course FeeEquipment Training – Aquanet EC-2000 - 4-Hour Equipment TrainingAvailable as a stand-alone program for all certified Colon Hydrotherapy practitioners.$400 Full Course FeeMembership to Canadian Association for Colon TherapistsMembership Fee $200Tax $ 0.00 CAD Surtax $ 0.00 CAD Payment MethodChoose OneCredit CardChequeEtransferCard Number*Expiry DateYear*Month*CVV*Please Mail Your Payment to: CANADIAN SCHOOL OF COLON HYDROTHERAPY 2351 Kennedy Road Unit 126, Scarborough, Ontario, Canada, M1T 3G9Please Send Your Payment to: firstname.lastname@example.org 416-291-4437 COURSES INCLUDE: A detailed course outline and binder will be provided on the first day of the course Refreshments will be provided during morning and afternoon breaks daily TERMS AND CONDITIONS: Tuition fees quoted do NOT include HST Lunch and dinner is NOT included - Local restaurant list available Accommodations are NOT included Guests suite may be available at a cost of $75 per night Each program may vary in times and hours depending on the number of participants. The daily schedule may be changed at any time without notice as needed. $500.00 (non-refundable) deposit due at time of registration. All tuition fees must be paid in full prior to the start of the course Payments preferred with cash, Debit or EFT Tests - last day of the course. We will ensure you have an opportunity to re-sit tests. Your certificate will be given upon successful completion of the course. REQUIREMENTS & WAIVER: I understand that upon successful completion of the course including case studies I must pass a series of tests to meet the CSCT requirements of Certification. Release: "I hereby release Canadian School of Colon Hydrotherapy and/or Free to Play Inc., and all branches and affiliations from all claims of damages arising from any accident or injury which is caused by or arises from participation of the applicant named herein, during any program or any facility or any location where a program is held". Confidentiality and Disclosure: Absolutely no part of the content in the copyrighted publications, course material or teachers’ notes, may be photocopied or adapted for teaching purposes or shared with anyone not taking the CSCT program. Breach of these restrictions will result in legal action. Agreement* I certify that I have read and understood the items outlined on this registration form. Total $ 0.00 CAD PhoneThis field is for validation purposes and should be left unchanged.