WORKSHOP
NAME
 DATE
See Calender for dates
CITY(s)
 PRIMARY
PRICE

Illusion of Fear
4Hrs.

See Event Calendar
Click Here
 -Grande Prairie
-Calgary
-Prince George
-$150.00 (In Town)
-$175.00 (out of Town)
F.I.R.E
Freedom In Releasing
Everything
See Event Calendar
Click Here
 -Grande Prairie
-Calgary
-Prince George
-$150.00 (In Town)
-$175..00(out of Town)

T.E.A.M.
Together Everyone
Attracts More!

See Event Calendar
Click Here
 -Grande Prairie
-Calgary
-Prince George
 Price based on length of
Event and Number of
Participants.

Walking Through the
Looking Glass

See Event Calendar
Click Here
 -Grande Prairie
-Calgary
-Prince George
-$99.00 (In Town)
-$110.00 (out of Town)
IN TOWN workshops are based out of the Grande Prairie Area - OUT OF TOWN workshops are workshops booked outside of the Grande Prairie
area and have a higher price to cover Traveling expenses for our team.
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Hello and Welcome To
www.Firewalks.ca
Power of Intention - Breakthrough Coaching Inc.
We Specialize in customizing your personal Fire walking  Experience!!
Workshop Registration Form
Workshop Registration Form - Step #2
FRIEND / FAMILY- INFORMATION
Workshop Registration Form - Step #1
PRIMARY INFORMATION
Family /Friend
Name:
Mailing
Address:
Phone Number:
E-Mail:
Workshop
Name
Workshop
Date / Location
Primary Name:
Mailing Address:
Phone Number:
E-Mail:
Workshop Name
Workshop
Date / Location
Workshop Registration Form - Step #3
METHOD OF PAYMENT
 Workshop Registration Form -
Step #4
SUMMERY
Name on Card
Cash
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Master
Card
Deposit
Amount:
Number of
People:
Workshop:
Date and
Location:
Total Cost:
Amount
Deposited:
Method of
Payment
Card Number
Exp.
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I have read and understood all portions of the registration form and agree to the terms and conditions regarding
cancellation and transfers of programs and courses. CLICK HERE TO READ MORE
I understand that Power of Intention - Breakthrough Coaching Inc. Respects my privacy and agrees not to sell or trade my
information with third parties and that all information given is for the soul purpose of processing my transaction.
Official Home of  Guinness World Record Fire Walk
Holder Amanda Dennison
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