Massage At Monroe
Pain & Stress Management & Rehabilitation Services
Hot and Cold Stones and Hot Bamboo

Hot and Cold Stone and Hot Bamboo Registration Form.

 

October 28,29 2017

 

Massage At Monroe , Monroe, NC 28110 704 221 5872

 

Name: __________________________Title:___________ License # ________

Street: ______________________________________City: _______________

State: _________Zip: ______________ Email: _________________________

Phones: (W) ____________________________(C)_______________________

 

 

October 28,29 2017                   14 hours       $299 _______

 

Payment options:

1)   Online payments

2)  Preferred method of payment: Check.

     Make Check payable to Massage At Monroe and mail to:

     Massage At Monroe, 2325 Hanover Dr, Monroe NC 28110.

3)  Credit Card # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Exp _ _ / _ _ 3 digit code on reverse _ _

_________________________________________________________

Signature (I agree to Grand Total charges above) Fax to 704 282 4683

For any additional questions or registration by phone please call Carmen at 704 221 5872.

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