Course Registration

Register for an Education Class / Workshop

(OPTION 1)
Download Registration Form (PDF)

Send in your check with this registration form made payable to:

The Muscular Wellness Institute
783 Route 3A, Bow, NH 03304

(OPTION 2) Fill out our Secure On-line Registration Form

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Education Class/Workshop Registration Form

Student Information

(* = Required)

*Name:

License:License State:

*Address:

* City:

*State: *Zip:

Phone: Cell Phone:

* Email:

Course Information

How did you find out about the course?

*1st Course Name:

*1st Course Price:

2nd Course Name:

2nd Course Price:

Credit Card Information

*Deposit Amount:

(**Minimum deposit required to hold your space is $100.)

*MasterCard Visa

*CardNumber:

*Expiration Date (MM/YY): /

* CVV2: (Last 3 numbers on the back of your credit card)

*Cardholder Name:

Deposits are fully refundable up to two weeks prior to the start date of the program and transferable if cancellation is less than two weeks prior to the start date. A $25 admin fee will be deducted for all transferred deposits. All transferred deposits must be applied to another program within a year. Deposits are refundable in full if MWI has to cancel a program for any reason.