Booking Form for Introductory Course in Craniosacral Therapy

Please print off this form and send it off to the address below.
Please complete in Block Capitals. Thank you.

Name ......................................................................

Address................................................................................................................................

............................................................................................................................................

......................................... Postcode ....................................

Phone No ...............................(Home) ...........................................(work)

Email address ...............................................................

Occupation ......................................................................

Qualifications in other Therapies/modalities (if any) ............................................................................................................................................

Please book in on the following course(s):

Intro course .............. or ...............(dates*) ....................................... (location)

Have you done any previous training in Craniosacral Therapy? If so, please state when and with whom you trained ..................................................................................................................

Where/how did you hear about this course? .............................................................

I am willing and able to bring a therapy couch for the course YES NO

I enclose my deposit of £20.00 made payable to Cranionatal.

Signed .............................................................. Date .............................................

Please return to: Cranionatal, Wyndham Barns, Corton Denham, Sherborne, Dorset, DT9 4LS
Tel 01963 220991 for enquiries