Book Summer Soundhealing Intensive

Summer Soundhealing Intensive

Name: *

Surname: *

Email: *

Address: *

City/Town : *

Province/county:

Postal Code:

Telephone: *

Mobile/cell phone:

Website:

How would you rate your knowledge/experience with Sound? :

Beginner

Intermediate

Advanced

Are you a therapist or health practitioner in alternative or allopathic medicine?:

Please explain

Have you experienced altered states of consciousness while listening to music or drums?:

Have you suffered from a serious medical condition or chronic illness?:

Please explain

Are you taking medication? For what purpose?:

I agree to pay the first payment of €200 as a deposit and commitment to attend the Intensive: *

Please complete payment of deposit in our shop, once you submit the form you will be redirected to the Payment Page.

The remaining €575 I undertake to pay upon registration at the Dome : *

Additional Information: