Mary Spire Institute For Optimal Movement

Mary Spire

Registration Form

I would like to register for the following (please check):

____

One-Day Awareness Through Movement Intensive
$85

Marin

Sun.

1 pm - 5 pm

I would like to attend on the following dates:

____	Jan	15
____	Feb	19
____	March	18
____	April	15
____	May	20
____	Sept	16
____	Oct	21
____	Nov	18
____	Dec	16

____
Optimal Moves for Musicians : A Workshop for Musicians, Music Educators and Health Professionals $100 each day

San Francisco Sept 2 10 am - 5 pm

____
Advanced Training and Mentoring Series:

"Viewing Moshe"
$75

Berkeley Sun. 12:00 pm - 5 pm

I would like to attend on the following dates:

____ Jan 29

____ March 25

____ Oct 28

____ Neurological Conditions Series: Stroke and Dystonia, $100 each day
TBA, 12:00 p.m. – 6 p.m. Berkeley, California

____	Working with Infants and Children, $100 each day TBA - 12:00 pm - 6:00 pm, Berkeley, California

To pay by check or money order:
Print and complete this form, enclose your check or money order made payable to Mary Spire, and send it to:

Mary Spire
1402 Solano Avenue

Berkeley, CA 94706

To pay using VISA/Mastercard:
Print and complete this form, including credit card number and expiration date, and fax or e-mail it to maryspire@optimalmoves.com.

Name:_________________________Phone # :_______________________

Address:______________________________________________________

City:___________________________State:______Zip:_________________

Visa/MasterCard # :_____________________________________________ Exp. Date:___________

Total Amount Enclosed________________

Pre-registration and advance payment required. Refunds given with 2-week cancellation notice, minus a $25.00 processing fee. Confirmation and further information will be sent upon receipt of registration.

Contact Mary for more information.

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