REGISTRATION FORM Tutor: Puk Johansen I am excited that you wish to join the EMMETT for HUMANS training programme. Class sizes are limited so register early for the best chance of obtaining a place! First name (required) Last name (required) Email Address (required) Mobile Number (required) Which course are you interested in registering for? (required) —Please choose an option—Human WorkshopFoot Care WorkshopModule 1&2Module 3Module 4Module 5Module 6Module 6 Review and Client Clinic DayAdvanced EP1Advanced EP2Advanced EP3Advanced EP4Advanced EP5Advanced EP6EP Practitioner Day (EP3)Advanced LymphaticsPelvic CarePractitioner Day - Upper Body M1-6Practitioner Day - Lower Body M1-6Human Workshop Tutor Training Choose Course Start Date (required) Course Location (required) Instructor Name (required) HOME ADDRESS DETAILS House Name/Number (required) Road/Street (required) Please leave this field empty. Town/City/Village (required) County (required) Postcode (required) Country (required) Where did you hear of this course? (required) Are you repeating this course? (required) YesNo Can you bring a massage table? (required) YesNo Please let us know if you have any other questions Course Fees Human Workshop - £130 or €150 Human Practitioner - £350 or €400 per level Advanced Practitioner EP, Advanced Lymphatics and Pelvic Care - £370 or €420 per level Students may repeat any individual one or two-day course for half price. Repeating only one-day of a two-day course will be charged at 75% of the course price. The course fee balance is to be paid at least 4 weeks prior to the course start date. The instructor will respond to you shortly with payment details to secure your place. Payment options include bank transfer and in some cases PayPal for credit & debit cards. Cancellation Policy Full refunds will be given for cancellations up to 21 days prior to a course, minus the non-refundable deposit. 50% refunds will be given for cancellations within 20 – 2 days (48 hours) of a course. No refund will be given for cancellations within 48 hours of a course. Note: Every effort is made to ensure courses go ahead as scheduled however, courses may be cancelled or postponed at short notice. You may wish to seek cancellation insurance or choose refundable transport / accommodation. Under these circumstances, your course fee will be refunded. Please refer to www.emmett-uk.co.uk for the full Refund and Cancellation Policy. Privacy Policy and T&Cs HQ and UK & Ireland Please refer to www.emmett-uk.co.uk/ for the full UK & Ireland Privacy Policy. Privacy Statement UK & Ireland: (Tick to give your permission) Please refer to www.emmett-technique-hq.com for the full HQ Privacy Policy. Privacy Statement HQ: (Tick to give your permission) Please refer to www.emmett-uk.co.uk/ for the full UK & Ireland T&C. Terms and Conditions UK & Ireland: (Tick to give your permission) Please refer to www.emmett-technique-hq.com for the full HQ T&C. Terms and Conditions HQ: (Tick to give your permission) I understand that by supplying my contact details I give my permission for the course instructor to pass my contact details to EMMETT Technique UK and Ireland (ETUK) and EMMETT Technique Head Office so that I can be kept informed of important EMMETT Technique information. I understand I can request my details to be deleted at any time.