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Registration Form

 



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Registration Form

Personal/Professional Details

Title:

Surname: (please enter your name exactly as you wish it on your certificate)
Forename: (if you do not use your name as written here please add your short name or nickname in brackets)
Therapy/Qualifications*:

*It is assumed that you are a professionally established and qualified healthcare practitioner. Any doubts about this must be raised with us in case the signing of an appropriate Waiver is required.

Address/Contact Details
Postal address including postal code and county:
Country:
Telephone home:
Telephone work:
Mobile Telephone:
Contact phone for public**:
Fax:
E-mail:

Website:

Course details
Name of course:
Start date of course: Day: Month: Year:
Course location:
Equipment you can bring: treatment table
  yoga or camping mat
Other

If this is your first Barral Institute UK course,  how did you hear about us?

**Please indicate whether you would like your name and public contact number to be published upon completing the course in  directories of visceral manipulation and online at www.iahp.com.

Yes, please publish No, I do not wish to have my name listed.

I understand that all of the above information will be relied upon in confirming my place and in setting up my file.  I have read and agree to the cancellation policy.  I understand I will not receive confirmation of my registration until my deposit is paid

Payment

Please note a deposit of £200 is required to secure your place on the class.  If you are international you are expected to cover all bank fees.

Cancellation Policy

Cancellations will be subject to a £50 fee if made 2 calendar months or more prior to the first day of the course. If you give less than 2 calendar months notice that you are unable to attend the class the full deposit of £200 will be forfeited. 

 

For classes taught by Jean-Pierre Barral or Alain Croibier personally the period for cancellation is extended  so that a £50 fee is chargeable if made 3 calendar months or more before the first day of the course. If you give less than 3 calendar months notice that you are unable to attend the class the full deposit of £200 will be forfeited. 

 

We will transfer prepayments less the cancellation fee to other courses/dates, otherwise they will be refunded, less the cancellation fee.

 

 

Select payment method: Cheque
Bank Transfer
Credit/Debit card (4% processing fee applies)

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Address: Barral Institute UK

26 Miller Road

Ayr KA7 2AY

Tel/fax: 01292 266335

Email: info@barralinstitute.co.uk