CE Class Registration
Complete your Class Registration by completing this form:
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Email *
For which class are you registering? *
Student Legal Name (your preferred name can be listed in the next section): *
If you prefer a different name (legal or otherwise) for your certificate, please provide YOUR CHOSEN name for your certificate below: If your legal name above can be used for your certificate, please skip this question. *
What is your Massage Licence # ? This is needed for reporting your CE credits to CE Broker to alert your state board that you have completed this course. PLEASE include all "0" Zeros in the #. Your LMT # should look like this: MT009918 *
I understand that by attending this adult continuing education class I may be filmed or photos may be taken for class marketing purposes in the future. Use of these audio clips / video recordings / photographs will be used exclusively for marketing purposes and nothing beyond. By signing below I understand that I am waving all rights to use of any photos for my own purposes. I give full permission to Ivy and ECHO Healing to use my likeness for ECHO educational purposes and future marketing / advertising purposes.   *
The classes offered by ECHO Healing are for adults only. Because we teach anatomy and techniques to help clients heal from medical conditions and physical pain we may at times have a model who is disrobed or nude for educational purposes. Our classes for our Transgender Communities usually have a model and speaker who will provide students an opportunity to learn by palpating scar tissue that may require exposing breast tissue.  Although genitals will never be exposed in class, your Student Handbook may contain nudity that does include genital exposure. *
What drew you to this CE Class? Choose as many options as you'd like. *
How did you hear about ECHO Healing CE classes? *
Required
What other classes are you interested in? *
Required
Emergency contact  name & number *
After you registered and paid for your class you should have received a link to several downloadable documents, including a WELCOME LETTER. I verify that I have read this WELCOME LETTER and accept all conditions and responsibilities as a student of ECHO.  Please electronically sign below by typing your full name: *
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