CE on SAFARI  Information & Registration
Event Timing: Depart USA - October 14th - Depart Kenya October 28th
CE ON SAFARI-KENYA

Please complete this form if you are interested in receiving information on the CE on SAFARI program.  You MUST be a fully licensed USA Massage & Bodywork Therapist to be the primary participant of the program.
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Email *
First Name *
Names MUST appear as in your Passport
Middle Name/Initial
Names MUST appear as in your Passport
Last Name *
Names MUST appear as in your Passport
Email *
Phone Number *
Street Address *
City *
State *
License Information (Must be Valid)
Required ONLY if you are attending for CEs. Indicate Names as should be in the CE Certificate
Are you traveling with a companion? *
Companion Must be an Adult.  Limit 1 companion
If Yes, Please give full Names of your Companion.
Complete if you are traveling and bringing a companion
Are you FULLY  vaccinated Against COVID-19? *
It is a REQUIREMENT that all travelers to Kenya MUST  be fully vaccinated against COVID-19 and have Vaccination Record
Dietary restrictions *
By signing my initials below, I give permission to  the CE on SAFARI Coordinator to send me information on the program. *
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