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Training Enrollment form
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Name
*
First
Last
Date of birth
*
DD/MM/YYYY
Email
*
Contact Number
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Please tick the course/s you are interested in
*
Indian Head Massage – Half day program
Ayurveda Masssage Therapist – Full day program
Ayurveda Therapeutic Masssage – Half day program
Lymphatic Drainage Massage – Half day program
Ayurveda Massage Massage – Half day program
Sirodhara Massage Massage – Half day program
Healthy Cooking workshop – Half day program
Marma Point Massage workshop – Half day program
Gut Health and Healthy diet – Half day program
Fundamentals of Ayurveda – Half day program
Skill development training for Ayurveda doctors and practitioners – 6 Weekends
Select the course you paid for
Do you have any special needs required to support your training. We support people with disability recieving our training.
Yes, Will be discussed with trainer prior to the commencement
No
How did you know about AyurHealth?
Word of mouth
Internet / Social media
Practitioner referral
Other
Informed Consent:
*
I understand my physical and mental health is good to undergo the training.
I have viewed/discussed and confirmed the trainer qualifications.
The basic outline of training and venue will be asked and explained prior to commencement.
I know I should make full payment prior to the commencement and cannot be refunded if I commenced the training.
I will complete the assessment required satisfactorily to recieve the certificate.
The courses offered at Ayur Health are government unaccredited and no fee support from the government.
The skills I learned to improve my existing practice / business and expand my scope.
Do you agree with the above information?
*
Yes
No
You may contact 0470 169 933 and clarify if you have any disagreement.
Electronic Signature (write FULL NAME)
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Date of the training at Ayur Health
If there are multiple sessions, provide first session date. If you are not sure, leave it blank
Date
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Date of the completion of this form
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Detox drink – Virechana
Pancha Karma – Detox
