Course Registration

Module One

2nd November to 4th November 2019
Dove House, Auckland, NZ
Facilitated by Tania Shaw

Full Name *:
Email *:
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Address * :
Phone * :
Mobile * :

Could you please provide the name and telephone contact details for your emergency contact or next of kin? :
OML seeks to accommodate anybody who is interested in our programs but we may require advance notice to adequately prepare and adjust the learning experience. If you believe you have any medical conditions - eg, dyslexia, hearing loss, sight impairment, and/or mobility - or other attributes - eg, English as a Second Language - that may limit your learning experience, please contact us on 0416 004 616. *:
Are you able to bring your own massage table?
You may incur a fee for hire if insufficient tables can be supplied by students. *:
yes   no  
Do you have an up-to-date First Aid Certificate? : yes   no  
Do you have Public Liability insurance? : yes   no  
Do you have Professional Indemnity Insurance? : yes   no  
Are you currently working as a massage therapist? : yes   no   part time  
Do any of your massage clients have a diagnosis or history of cancer? : yes   no  

Qualifications :

Non Massage Qualifications:

How did you hear about this program?:


Your Payment: Pay Full Amount or Depost (min $50)

*NOTE: Please click here for more information on payments or cancellations

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