Class Registration

Thank you for your interest in attending

Please make sure to fill in all fields and text boxes.

Full Name:

Email address:

Phone (including area code):


City/State/Zip: / /


Please tell us a little about your experience with Energy Medicine - have you studied any Eden Energy Medicine or any of Ellen Meredith's work ? (pre-requisite for this class is one year of EEM training or permission from the instructor):

What are your hopes or expectations for this class (if any)?

Are there any health, mobility, mental health, or learning issues we should be aware of?

Additional details will be sent with confirmation of registration.

By submitting this form I certifiy that all the information is accurate.

If you can read this, please don't touch the following text fields.