Please print out this form to register or call (773) 271-3054.

CHAKRA ANALYSIS & ENERGY HEALING INTENSIVE

3 Day Weekend Retreat - - $379

Prerequisite, at least four individual chakra classes and one private session.
Friday August 11th 11:00 a.m. until Sunday, August 13th at 5:00 p.m.
Location : a peaceful park setting on the beach in Chicago.
Over-night Friday and Saturday recommended , but not required.

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Name____________________________________________________________________________

Address__________________________________________________________________________

City, Sate, Zip_______________________________________________________________________

E-mail Address_____________________________________________________________________

Phone______________________________________________________________________________

A DEPOSIT OF $100 IS DUE BY AUGUST 1, 2006 TO RESERVE YOUR PLACE

BALANCE DUE UPON ARRIVAL

If you need to make payment arrangements, please confirm in advance.

Checks can be made out to Blanche Blacke and mailed to: PO Box 269072, Chicago IL 60625

Or: $100.00 Deposit via:

Credit Card #________________________________________________________Exp. Date__________

Signature______________________________________________________________________________

 

 

Location : a peaceful park setting on the beach in Chicago.

Over-night Friday and Saturday recommended , but not required.