Event Registration

The Laughing Body: Art of Care
08/16/2019 - 08/23/2019

Please take a moment to complete this form and ensure your information is correct. If registering multiple participants, please fill out an individual registration form and payment infomation for each individual. * Required Fields  

The TOTAL COST for this trip is $800.00/each participant. 

Deposit is non-refundable.

Personal Information

/ /

Contact Information

-

Additional Information

Travel Information

Emergency Contact Information

Create your Gesundheit account below! (i.e., view and print donation history, update profile, etc.) Please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.

required fields

Powered by NeonCRM  

Patch Adams MD & Gesundheit Institute, P.O. Box 307, Urbana, IL 61803

© Copyright 2018 Gesundheit! Institute - Non-Profit Web Design by Idea Marketing Group