MCKS YOGA VIDYA PRANIC HEALING

CENTER BAREILLY
AFFILATED TO -MCKS YOGA VIDYA PRANIC HEALING
OF UP.

TRUST

(AFFILATED TO THE WORLD PRANIC HEALING FOUNDATION INC.

MANILA, PHILLIPINES)
BRANCH OFFICE DAYA KUTI MACNAIR ROAD PREM NAGAR NEAR TARUN HOSPITAL
BAREILLY PIN CODE- 243005

REGISTRATION FORM
(PLEASE FILL IN BLOCK LETTERS)
NAME..
QUALIFICATION- D.O.B-...
ADDRESS (Resi).
PIN CODE ...
PHONE-.
EMAIL-.
PRANIC HEALING PROGRAMES ATTENDED BASIC/ADV./PSYCHO/CRYSTAL/ANY OTHER

DECLERATION- I am participating in this Yoga Vidya Pranic Healing Workshops of my own will and take full
responsibility for doing the same. I release MCKSWVPHT of UP. Lucknow Organizers/ Trainers of this workshop
from all damage what so ever and waive all rights to compensation in case of injuries. I declare that I am physically
and mentally able to participate in this workshop and will keep confidentiality of the proceedings.
PLEDGE- I will not teach Pranic Healing to any one, unless I am specially trained and authorized to do so by the
World Pranic Healing Foundation.

Place-.
Date..
I am enclosing Rs- (Rupees).
Trainer- GP.CAPT SP .SAXENA / ABHEY KR. JOHARI / INDUSH JOHARI.
(FOR OFFICIAL USE ONLY)
Received application form with rupees .. (Rupees as fee)
From..onfor.workshop to
be held on
Venue * DAYA KUTI PREM NAGAR MACNAIR ROAD NEAR TARUN HOSPITAL BAREILLY.