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Group Healing Registration Form

I wish to attend the group healing being conducted on 5th February 2012, Sunday in Rohan Vasantha, Bangalore

 

Personal Details

Name
Reiki Level 1 2 3A None
I'm likely to arrive at the time
I'll probably stay for
I will bring along friends
We'd need lunch for people (Approx Rs. 100 per person)
 

Contact Details

Email ID
Mobile/ Phone Number

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