ERIK PAULSON
(1/21/17-1/22/17)


How did you hear about the seminar?:

First Name
Last Name
Date of Birth
Email (required)
Phone # (required)

Street
City
State (PA, NY, MD)
Zip Code
Gym/Instructor’s Name

Which Day(s): (required)

TIER 1:
1 day: $85 2 days: $150 (Spots 1-15)

TIER 2:
1 day: $95 2 days: $175 (Spots 16-30)

TIER 3:
1 day: $105 2 days: $200 (Spots 31-45)
TIER 4:
1 day: $115 2 Days: $225 (Spots 46-60)

OR

After JAN 15TH: $125 for 1 day, $235 for 2 days

**NO Refunds unless Seminar is Canceled**

Additional Comments: