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Special dietary requirements:
I am attending Heartworks Lomi Lomi- Level 1 - DATE:
I am attending Heartworks Lomi Lomi- Level 2 - DATE:
I am attending Heartworks Lomi Lomi- Aloha - DATE:
I enclose Being deposit ($200 non refundable) / full payment for the course

All cheques payable to 'HEARTWORKS LOMI LOMI'
I understand full payment is required before course commencement

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Do you have transport?
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How did you hear about the course?
Method of payment:
Cheque Money Order Cash Bank Transfer
I understand that the $200 deposit is non refundable:
  yes no
 

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