Registration Form


Print the following form and fill in blanks

Your Name:

Phone Number:

Address:

City/State/Zip Code:

Name Of Workshop:

Date of Workshop:

Please mail your registration information with a check for $25.00 to

The Institute for

Men's Health and Well-Being

2629 Upton Avenue North
Minneapolis, Minnesota 55411

Workshop size is limited, so send your registration at least seven (7) days prior to the workshop.

Make your check payable to Conscious Bodywork Associates.

Copyright © 2003 Jim Lovestar All Rights Reserved.