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Registration Form: The Healing Way
For classes designated as offered through Frederick Community College (FCC), do not use this form. For classes offered through FCC, you must register with the college, www.frederick.edu. 301-846-2400
For all non-FCC classes and activities, complete this form and mail it to the address below. Or, you may register by phone (301-696-8380) with a credit card - Visa, MasterCard, Discover.
The Healing Way
250 West Patrick Street, Suite 1
Frederick, MD 21701
Name ________________________ Phone _______________________
Address ______________________ Email ________________________
City, State ____________________
Zip Code ______________________
Name/Title of Activity or Event Date/Time Amount Due
__________________________________ ___________________ _____________
__________________________________ ___________________ _____________
__________________________________ ___________________ _____________
__________________________________ ___________________ _____________
__________________________________ ___________________ _____________
__________________________________ ___________________ _____________
Total Amount Due: _____________
Please note: Fees for registrations cancelled more than 72 hours before the scheduled refund are 50% refundable. Fees for registrations cancelled less than 72 hours before an event are 100 % non-refundable. Should a class or event be cancelled by The Healing Way, all registration fees will refunded.
Method of Payment: (Payment is required to complete your registration and reserve your space.)
____Check (Payable to The Healing Way) OR ___ Credit Card (Master Card/Visa)
I authorize The Healing Way to charge my MasterCard/Visa (circle one) for $_______
Name on Account: _________________________
Account # ________________________________ Expiration Date ________
Signature ____________________________________
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