seminar registration

For your convenience you may register any one of three ways.
  1. Print the form, fill out and fax to (305) 378-4107
  2. Mail in form to: Advanced Rehab, 7641 SW 126 St, Miami, FL 33156
  3. Call (305) 378-0855 and an operator will assist you. (9:00am - 5:00pm est)

A confirmation notice will be sent within five days of receipt of payment. Seminar site and hotel information will be provided with the confirmation notice. Contact for more information.

First Name:   Last Name:

Title:   Phone (Daytime):

Address:

City: State: Zip:

Facility:

E-mail:

Course Title: Location:

Visa/MC No.:__________________________________   Exp Date:______________

Name on Card:________________________________   Amount (US):$__________



Cancellation Agreement
If written notice of cancellation is recieved prior to 21 days of the course date, a full refund of tuition will be made minus $75.00 administrative costs. No refund will be made for cancellations made less than 20 days before the course date. All non-refundable monies (less $75.00) may be applied to another course offered by ADVANCED REHABILITATION THERAPY, INC. We reserve the right to cancel or change the dates of the course up to 14 days prior to the course date. Participants will be notified by the most expedient means. Course fees only will be refunded


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