Enrolment Form

Please complete the enrolment form below to secure your place on our current course dates. After completing this page, you will be asked to pay the £100 deposit via PayPal. You do not need a PayPal account and can pay by credit card.

If you prefer to pay the deposit by cheque, please send a cheque for £100 (made payable to MamaBabyBliss Ltd) to MamaBabyBliss Ltd, 14 The Chilterns, Hitchin, SG4 9PP. Your space on the course will be confirmed once we have received your cheque.

In the unlikely event that you are not eligible for the course or the course is full, then the deposit will be refunded.

*** AUTUMN PROMOTION! ENROL BY FEBRUARY 14TH 2012 AND RECEIVE A DISCOUNTED RATE OF £850 (THIS IS A SAVING OF £145 OFF THE FULL PRICE)***

Please complete all mandatory fields marked with an *.

Name*		Email*
Address		Phone
		DOB
		Website
Preferred time for telephone interview:		Morning Lunch Afternoon Evening
MamaBabyBliss Integrated Baby Massage and Baby Yoga Diploma Course Dates 2011/2012 Course A (Fully Booked) Part I January 17th, 18th & 19th, 2011 Part II May 9th, 10th & 11th, 2011 Course B (Fully Booked) Part I March 7th, 8th & 9th, 2011 Part II June 27th, 28th & 29th, 2011 Course C Part I May 16th, 17th & 18th, 2011 Part II September 19th, 20th & 21st, 2011 Course D Part I September 12th, 13th & 14th, 2011 Part II January 9th, 10th & 11th, 2012 Course E Part I November 7th, 8th & 9th, 2011 Part II February, 27th, 28th & 29th, 2012 Course F Part I January 16th, 17th & 18th, 2012 Part II May 14th, 15th & 16th, 2012 Course G Part I March 5th, 6th & 7th, 2012 Part II June 25th, 26th & 27th, 2012 Course H Part I May 14th, 15th & 16th, 2012 Part II September 17th, 18th & 19th, 201
Which course would you like to enrol on to?
Please give a brief an outline of why you would like to teach baby massage and baby yoga*:		Please list any relevant qualifications and professional experience:
Please tick if you are interested in becoming a MamaBabyBliss Associate Teacher
How would you prefer to pay for the course?		Cheque Bank Transfer Instalments¹
Please enter the code into the box:
I have read and accept the payment & cancellation terms & conditions: