Registration Form

Registration Form

The information below will be saved by the Conscious Health School Amsterdam in order to compose an invoice for the chosen activity.

If it concerns a Bars®, Body Process or Energetic Facelift Class from Access Consciousness®, your name and email address will also be used to register your class participation at Access Consciousness. If you pertinently do not want this, you can inform us via the contact form.

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

By completing and sending this registration form you agree to the saving and passing on of this information.

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:

    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:

    Applies for the following course:

     

    I agree that the data entered above will be saved and used for registration at Access Consciousness

    I agree with the General Terms and Conditions

     

     

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    Still problems with registration?  Please contact us!  020 - 493 1650