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Complete this form to register for a currently scheduled training or to let us know you are interested in scheduling one around your availability.

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Name: *

Street Address: *

City, State, Zip Code *

E-mail address: *

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Cell Phone # *

Other Phone #

The Next Training is on June 29 & 30. What dates are you are available for a 2-day training?

How did you hear about the training? *

How many laughter classes have you been to and where? *

Why do you want to take the training? *

What do you plan to do as a certified leader, if anything? *

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You must pay the registration fee in full in order to reserve your space.

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