AMERICAN AQUANATAL INSTRUCTOR CERTIFICATION
The Basic and Advanced American AquaNatal Course

Total fee is $685.00 (with a none refundable $100.00)
If registering a month in advance it is $640.00

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Registration form

Please Print, fill out and Mail to:

Marina Alzugaray
PO Box 3957
Santa Barbara, CA. 93130 USA

Make check payable to Marina Alzugaray

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I would like to attend

The American AquaNatal Instructor Certification Workshop

Program dates::_____________ - ____________

Name:__________________________________________________________

Address:________________________________________________________

_________________________________________________________________

City ________________ State ______ Zip______________ Country ______________

Phone:
Home:_________________________ Work ____________________ Cell____________
Best contact # and time to call ____________________________________________________

Email:_______________________________________________________________

Amount enclosed: $ ______________

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Credit Card Payments, fill out and mail or call Marina 305-744-3370
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Visa | Mastercard | American Express | Discover
circle card type:

CARD #: __________________________________________

EXP Date:__________________________________________

CCV# on back of card _________________ ( last 3 digets on back of card near signature )

  Please Fill out unless Billing info is the same as above
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Name on Card __________________________________________________

Card Billing Address:_________________________________________________________________

 _________________________________________________________________

City ________________ State _____

Zip______________ Country ______________

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Do you require CEU's

License Type and #______________________________________________________________________

License Type and #______________________________________________________________________

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You will receive a letter of confirmation upon registration and your instructor plan information.

The fee includes:
Help with the instructor plan
The training, course materials, and instructor book.

The fee does not include transportation, lodging or meals

We like to make your trip a great experience!
Let us hear from you soon
We hope to be in the WATER with YOU soon

Thank You,

Marina Alzugaray MS, CNM/CPM
Email Marina
(305) 923-0382