Energy Exercises Class Registration

Step 1: Payment — Pay first. Submit $75. This is required. If you do not pay, you will not receive the link.

Payment options:

Venmo: polarity_therapy
Zelle - send payment to polaritytherapyinstitute@gmail.com
Credit Card (Click here for link)

Step 2: Registration: Fill out the form below. This is required. If you have not registered, you will not receive the link.

Step 3: Access: if you have paid and registered, the zoom link will be sent prior to class to the email registered. Please allow 2-3 business days to process your request. If you are purchasing the video recordings of this class, the video links will be sent to the email registered once available.

NOTE: By registering you agree to the informed consent & video release form. All classes are recorded and your image may be included if you participate in class.

Name

First Name

Last Name

Preferred Pronouns

Phone

(###)

###

####

Checkbox

I have read, understand and agree to the contents of the informed consent and video release form. I understand there are no refunds for this event but a video link will be sent if I’m unable to attend. I understand the link sent to me after the class is intended for paid participants only, and sharing it with others is a violation of copyright law.

I wish to attend:

Live Zoom Classes (2/16, 2/23, 3/2, 3/9, 3/16)

Via video recoding

I have paid by:

(If you have not paid already, please make payment prior to submitting this registration form; instructions are above the form under “Step 1”)

Credit card

Venmo

Zelle