THIS IS NOT AN ONLINE REGISTRATION FORM - FOR PRINT ONLY            Printed Date: 3/28/2024 6:11:57 AM

Seminar Title:
RockTape Hosted Zoom Event: 2-Day Movement Specialist Certification: Conscious and Subconscious Movement Assessment
Seminar Date:
Saturday, May 30, 2020
Seminar Location:
,
Seminar ID:
83334

  Required (select one)
  Registration: $275.00

Registration includes FREE Participant Movement Kit with Registration (FKIT086090).

Please make sure your address is correct for shipping - contact PESI Customer Service if your address needs to be changed.


Connection instructions will be emailed a few days prior to the webinar.


  ________ HI, NM attendees add applicable sales and local taxes**
  ________ Subtotal (Required items + sales tax)
 
  Optional
 
$350.00 RockBlades 2.0: Complete Soft Tissue IASTM System
$175.00 RockBlades Mohawk
  ________ AL, AR, AZ, CA, CO, CT, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NJ,
NM, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY attendees add applicable sales and local taxes**
  ________ Subtotal (Magazines + Optional items + sales tax)
   
  ________ Total (Required subtotal + Optional subtotal)
  ** Tax-exempt customers please send a copy of your tax-exempt certificate.
  *** Registration for coordinator or military member discount must be completed online
  **** All prices are shown in US Dollars ****
 
 

Please enter the MAIL CODE in the box below.

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back in the box above the address block.

If you do not have a brochure, please enter 888.

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  Note: Leave Company/Department blank if providing home address
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  Prepayment is REQUIRED
  Check enclosed
  Signed Purchase Order enclosed
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Mail or Fax to:
PESI Kids, P.O. Box 1000, Eau Claire, WI 54702-1000      (800) 554-9775 (fax number)