Registration Form

The information below will be saved by Stichting Conscious Health School Amsterdam for communication with the registrant/participant and in order to create an invoice for the chosen activity if wanted. This information will only be used by Stichting Conscious Health School Amsterdam and will not be provided to third parties.

For a Bars® Class from Access Consciousness®, your name and email address will also be used to register your class participation with Access Consciousness. If you pertinently do not want this, you can inform us via the contact form.

This data will only be used by Stichting Conscious Health School Amsterdam and will not be shared to third parties.

By completing and submitting this registration form you agree that your data will be recorded by Stichting Conscious Health School Amsterdam and your (optional) registration at Access Consciousness.

The General Terms and Conditions and Complaints Procedure apply to this registration form.

You must complete all the fields below!

Mrs.Mr.

First Name:

Surname:

Address:

ZIP code:

Place of Residence:

Phone Number:

E-mail:

I see you have hotmail.
Please check your spam box for a few days because the registration confirmation may end up in there!

E-mail verification:

Is this your first Bars class or do you repeat the Bars class?

First Bars classI repeat the Bars classI am 16 or 17 years old

With whom and when did you attend your previous Access Bars Class(es)?

Enter your date of birth!

Applies for the following course:

I agree that my data will be recorded by Stichting Conscious Health School Amsterdam and with my (optional) registration at Access Consciousness

I agree with the General Terms and Conditions

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Still problems with registration? Please contact us via the Contact Form!

If you have not received a registration confirmation within a few days of registration?
Please contact us via the Contact Form!