Make-Up Registration Form :: Instituto Feldenkrais

Make-Up Registration Form

Greeting*

First name*

Last name*

E-Mail address*

Phone number

Street and house number*

Postcode*

City*

Country

We need your date and place of birth for our report to the Euro TAB.

Birthday*

Month*

Year*

Your place of birth (city and country)*

Your current training program*

SSL secured data transfer * required field

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