The Way of the Shaman®
The Shamanic Journey Power and Healing with Beth Beurkens, M.A.
REQUIRED WORKSHOP FORMS

Whether you are paying your tuition with Pay Pal, Check or Money Order,
you must fill out this two part registration form and mail it to:


Beth Beurkens, M.A. • P.O. Box 483 • Ashland, OR 97520

Along with your payment, this will complete your registration for the workshop. Thank You.

Mount Shasta, California
Saturday, September 10, 2016 - 9:30 AM to 5:00 PM
Sunday, September 11, 2016 - 9:00 AM to 4:30 PM
Registration:
Before August 10, 2016   $245.00
After
August 10, 2016      $265.00


REGISTRATION FORM
 

Name ____________________________________________ Phone __________________________

Address (include city, state and zip code)

_________________________________________________________________

_________________________________________________________________

Email ________________________________________________

Where did you hear about this course?

_________________________________________________________________________________


LIABILITY RELEASE FORM

Date _____________________________

I will not hold Beth Beurkens, Beth Beurkens Seminars, the Foundation for Shamanic Studies, Richard Russo, or Della Clark legally responsible for any injury, illness, accident or other misfortune that may occur in connection with my participation in the Way of the Shaman workshop at the Spiritwalkers Retreat Center in Mount Shasta, California on September 10 & 11, 2016.


Signature ____________________________________________________________

Printed Name ____________________________________________________________

PLEASE PRINT AND SEND VIA US MAIL. DO NOT EMAIL
Please include a registration form and liability waiver for each individual.

Beth Beurkens, M.A., P.O. 483, Ashland, OR 97520
beth@shamanicuniverse.com   www.shamanicuniverse.com