Reiki Training Intake Form

If you’re interested in obtaining training and certification in the practice of Holy Fire III World Peace Reiki, please complete the form below. If there aren’t any current classes listed in the Training Schedule, I can create a class that works for you. I need at least two interested students for this option to be available.

All information you provide is kept confidential and used solely to help me plan your training session.

Vertical sequence of color swatches in shades of blue and purple.

Name

First Name

Last Name

Phone

(###)

###

####

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

What class are you interested in?

Holy Fire Reiki Practitioner Level I/II

Holy Fire Reiki Master Level III

What class dates are you interested in?

Level I/II classes are typically held Saturday-Sunday and Level III classes are held Friday-Sunday. If this doesn't work for your schedule, please note your available days in the options below. I need at least 2 students to schedule a class to accommodate for partner activities and practice.

Have you had formal training in Reiki or a similar modality?

How did you find me?

Are you sensitive to perfumes, oils, fragrances, or incense?

Are you sensitive to light physical touch?

Although not absolutely required, there are instances where light physical touch may be used.

A non-refundable (but transferable) registration fee may be required to register for certain classes and sessions. If you are unable to attend the class or session you registered for, and you notify me at least 1 week before the scheduled date, you may transfer the registration fee to another available date of your choosing. If making your final registration payment via debit card or credit card through the website (www.MysticFox.us), your balance is due 2 days before the first day of class. You may also choose to pay your final balance via cash or check, in which payment must be made no later than the morning of the scheduled event. A minimum of 1 week notice is required to cancel your registration and transfer your deposit fee. Your deposit may be used toward another class occurring within 1 year of the original scheduled class or session date(s).

By electronically signing this form, I certify that I agree to the above Terms.

E-Signature

Today's Date

YYYY

Reiki Training Intake Form

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Mystic Fox Healing Center