Interest Form

Your form message has been successfully sent.

You have entered the following data:

Complete this simple form to let us know you're interested in EITHER attending the 2-day training on May 20 & 27 OR a 2-day training or 1-day leader refresher course on a different date.

Please correct your input in the following fields:

Error while sending the form. Please try again later.

*Name: *

Street Address

*City, State, Zip Code *

E-mail address: *

*Confirm E-mail address *

*Cell Phone # *

Other Phone #

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

*Why do you want to take the training? *

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

*Let us know if you want to attend the May 20 & 27 training or some other dates you would be available to attend a training *

Comments/Questions:

CLICK ON THE "Send Form" BUTTON BELOW. THEN, SCROLL UP FOR CONFIRMATION THAT YOUR FORM WAS SENT OR TO SEE IF THERE ARE ANY ERRORS

Captcha (spam protection code) *

Note: Fields marked with * are required

Return to Leader Training page

Web View Mobile View

Logout Edit page