Reiki Class Registration Form

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Congratulations on beginning or furthering your Reiki journey!

Before registering, please confirm class availability and your eligibility to participate with Kimeiko Hotta Dover (she/her/hers), Karuna Reiki(R) Master at reiki@kimeiko.com or (647) 557-6578.

When you are ready to register, please answer the following questions.

Email *

Which class are you registering for? *

Reiki for self care (non certification)

Reiki 1

Reiki 2

Reiki with Pendulums

Reiki with Crystals

Grow a Reiki Business (online, facilitated)

Reiki Master Practitioner (Reiki 3)

Reiki Master Teacher

Karuna(R) Reiki Master

Other:

Certification classes only: please type your name EXACTLY as you'd like it to appear on your certificate - First name Last name. *

What is your preferred name / nickname? *

What are your preferred pronouns (eg she/her/hers, he/him/his, they/them/theirs, etc.) *

Mailing address *

Cell phone *

Photo permission: May we take your photo? *

No, please don't take my picture

Yes, you are welcome to take my picture

Video acknowledgement for Grow a Reiki Business facilitated classes only: we record Zoom classes for student use only. *

I understand and agree to be recorded

I understand and will turn my video off so my image does not appear in the recording

Not applicable

Photo permission: May we share your photos? *

Please check the highest level of sharing you are comfortable with

Please don't share my photos with anyone

Yes, please share my photos with me

Yes, you can share my photos with me and my class

Yes, you can share my photos with me, my class, and the GTA Reiki private Facebook group

Yes, you can share my photos with me, my class, the private FB group and on social media

Would you like to be added to the GTAReiki mailing list to receive updates of classes, events, and community gatherings? *

Yes please!

No, thank you

Questions and comments

A copy of your responses will be emailed to the address you provided.

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