Sign up for Module 1

 

This is your registration for the training November 2023/September 2027 – Module 1.
Please read properly all information regarding training on www.erogenetic.com/erogenetic-education/.
Information about the deposit payment will be send to you in confirmation e-mail.

Your personal information serves for the lecturer and organizer only and will not be provided to any third parties.
If you need invoice please note it in the very last text field on this page.

    Name and surname

    Permanent address

    Date of birth

    Your email

    Phonenumber

    Do you have any restrictions, which can influence your participation?
    - physical restrictions, heart, blood pressure, epilepsy, asthma, infectious diseases - psychic issues, in psychic care or using medication - drugs usage - pregnancy

    Have you participated in a self-development or therapeutic workshop already?

    The training is self-experience and is often associated with certain physical and emotional demand. I declare that I take full responsibility for my health and material or other damages, if any caused. I will inform lecture before training to inform them about my phasical or psychical restriction if there are any.

    Please feel free to write us

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