Your one stop on-line source for all of  your Health Care & Self Care Needs !
IN TOWN workshops are based out of the Grande Prairie Area - OUT OF TOWN workshops are workshops booked outside of the Grande Prairie
area and have a higher price to cover Traveling expenses for our team.
Copy write Power of Intention - Breakthrough Coaching Inc.
And WWW,Butterflybreakthroughs.com (2006)
Welcome To
www.ButterflyBreakthroughs.com
Workshop Registration Form
Workshop Registration Form - Step #2
FRIEND / FAMILY- INFORMATION
Workshop Registration Form - Step #1
PRIMARY INFORMATION
Family /Friend
Name:
Mailing
Address:
Phone Number:
E-Mail:
Workshop
Name
Workshop
Date / Location
Primary Name:
Mailing Address:
Phone Number:
E-Mail:
Workshop Name
Workshop
Date / Location
Workshop Registration Form - Step #3
METHOD OF PAYMENT
Workshop Registration Form -
Step #4
SUMMERY
Name on Card
Cash
Cheque
Visa
Master
Card
Deposit
Amount:
Number of
People:
Workshop:
Date and
Location:
Total Cost:
Amount
Deposited:
Method of
Payment
Card Number
Exp.
Type signature
here
I have read and understood all portions of the registration form and agree to the terms and conditions regarding
cancellation and transfers of programs and courses. CLICK HERE TO READ MORE
I understand that Power of Intention - Breakthrough Coaching Inc. Respects my privacy and agrees not to sell or trade my
information with third parties and that all information given is for the soul purpose of processing my transaction.