Enrolment form Name Address Date of Birth Phone number Your Email Emergency contact Please indicate which Peter Hess Sound Massage training you are registering for? ---23-26/11/2019 - Sound Massage-Level III-IV - Perth WA30/11-1/12/2019 - Final & Supervision - Perth WA7-8/12/2019 - Sound Massage - Level I - Margaret River WA9-10/12/2019 - Sound Massage - Level II - Margaret River WA7-10/12/2019 - Block Sound Massage - I + II - Margaret River12-13/12/2019 - KLIK2 - Margaret River WA14-15/12/2019 - KLIK3 - Margaret River WA14-15/03/2020 - Sound Massage - Level I - Perth WA16-17/3/2020 - Sound Massage - Level II - Perth WA14-17/3/2020 - Block Sound Massage - I + II - Perth WA25-26/04/2020 - Final with Supervision - Melbourne1-7/05/2020 - Sound Massage - Intensive - Melbourne16-17/5/2020 - Sound Massage - Level I - Margaret River WA18-19/5/2020 - Sound Massage - Level II - Margaret River WA16-19/5/2020 - Block Sound Massage - I + II - Margaret River Medical Considerations Please identify any chronic physical or emotional conditions which may impact your capacity to fully participate in this course. - I am pregnant. YesNo I am fitted with a Pace Maker. YesNo I am taking prescribed medication. YesNo I suffer from a serious mental illness. YesNo Other. YesNo Media Consent By ticking the media consent box, you agree to PHAA taking photographs or videos of you as a participant. These images may be used for promotional material (included printed, digital or online format). I agree.I do not agree. Previous Training Please list all previous training in Peter Hess Sound Massage Method and attach a copy of course certificates ——— I accept the terms and conditions of Peter Hess Academy Australia training. [recaptcha]
