Family Constellations USA

Please read the workshop information page first, then choose your payment options:

Secure online payment

Check and Money Orders:

Print and fill out the Registration and Release forms below. Make your deposit payable to Brigitte Sztab and send to:

                    Brigitte Sztab
                    PO Box 724
                    Chelan,WA 98816

All deposits are refunded if cancellation is received ten days prior to workshop. A $35 cancellation fee will be deducted. For a refund after that date you may send somebody else in your place. Please notify Brigitte of any changes.

Please register me/us for the Family Constellations workshop on ________________

PLEASE PRINT LEGIBLY:

Name(s):
Name(s):

Address:
Address:

Phone:
Phone:

Email:
Email:

I/We will be attending as :

( ) Working participant
( ) Supporting participant/s
( ) Working Couple

PAYMENT OPTIONS:

( ) Enclosed is a $100 deposit (per person) to hold my/our place. Balance is due at the beginning of the workshop
( ) Enclosed is my/our full tuition of $__________ (please check dated fee schedule to detrmine your tuition)

RELEASE FORM

I understand that Family Constellations is a self-exploration workshop and not a substitute for medical treatment or mental health therapy. I am in good physical and mental health. If I am under the care of a physician or therapist, I have informed them of the nature of this work and have their approval to proceed.

Brigitte Sztab reserve the right to accept or reject any person as a participant at any time, and to make changes in the workshop or setting whenever deemed necessary for the comfort, convenience or safety of the participants, and to cancel a workshop at any time. In the event a session must be canceled, Brigitte Sztab shall have no responsibility beyond the refund of moneys paid to them by participants for that workshop.
By signing, the participant agrees that Brigitte Sztab shall not be liable for any damages, loss or expense occasioned by any act or omission by themselves or any other workshop participant.

Signed_______________________________Date_________