Register For Semimar/Training
(PRINT THIS PAGE & send by mail or fax)

Name______________________________________
Address____________________________________
City____________________State_____Zip_______
Phone -Home- (____)_____-_________________
Phone -Office- (____)_____-_________________
FAX (____)_____-_________________
e-mail ________________@__________

INDICATE BY CHECKING FOR WHICH SEMINAR/TRAINING ARE YOU REGISTERING?
Power With Balance ____ ($395/person)*     
Kids Are From Earth ____ ($199/person  OR  $299/couple)**
Basic Team, Leadership, Communication _____ (by contract

*Must be at least 18 years old to attend
**Must be at least 18 years old OR a parent to attend

Group/Corporate Tuitions and Programs are available. 
DO YOU WANT TO REGISTER YOUR COMPANY, ORGANIZATION, CHURCH, STAFF, FACULTY OR TEAM? _______

Name of Organization__________________________________________
Address____________________________________________________
City_____________________State/Prov_________Country___________
Name of Contact Person___________________Their Position__________

Are you paying by VISA____ or MasterCard_____ Discover Card______or Check_____

Cardholder's Name as appearing on Card____________________________
Card#____________________________________Exp Date___________
Amount to bill card = $______________(US)
Signature of Card holder__________________________________

Make Check/VISA/MasterCard To
Allied·Ronin™  Phone 707-769-0328
Mail payment & registration  to   P.O. Box 931 Petaluma, CA 94953
FAX payment & registration to 707-933-1246
e-mail: info@AlliedRonin.com