Wellness Clinics
WORKSHOP REGISTRATION FORM
(Please print and complete the entire form for each attendee for each workshop)
Name __________________________________________________________________________________
Business Name _________________________________________________________________________
P O Box/Street Address _________________________________________________________________
City _______________________________ State __________ Zip ________________________________
Email ________________________________________ Phone _________________________________
Business website ______________________________________________________________________
Which Wellness Clinic (Workshop) do you plan to attend?
Name of Workshop ____________________________________________________________________
City in which will you attend ___________________________________________________________
Date and Time you want to attend ______________________________________________________
Please send your registration to the address below with your check made payable to:
Leverage & Development, LLC.
Business Hospital for Women
507 Bluebird Lane
Greer, SC 29650
