Additional Payments Form

REQUIRED RECORDING POLICY

*Please review and check the required Agreement Confirmation at the end of registration page

Audio recording (no video) of your own individual lesson is permitted using your own portable recording device. Recordings are for your personal use only, and may not be reproduced or distributed in any format, without the expressed written consent of Michael Warren. No other audio or video recording is permitted.

Intensive lessons will be recorded for use in future educational material; by registering for this event, you agree to having your audio and video recorded. If you prefer not to be recorded please contact Dr. Warren at [email protected]

Name
First Last
Email
ADDRESS
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Lesson date/s or other notes
Additional Payments*
Please enter amount of payment here.
Total
$0.00
Credit Card
Card Details
Cardholder Name
Untitled*
- I have read and agree with the recording policy. (see above)

Additional Payments Form

Additional Payments Form

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