Myosfascial Restructuring Upper Quadrant:
Registration Form



If paying by check, use our printed registration form and mail it and your check to:
CPRC Kailua
Lynn Cambra - HAPTA
640 Ulukahiki St
Kailua, HI 96734
fax: 808-263-5058
If paying by credit card or PayPal, use the following 4-Step Process:
  1. Complete the following form, and click the Submit Form button when finished.

  2. You will see a Confirmation page. Click the link for Step 3.

  3. The next page you see will take you to PayPal where you can make payment using your own PayPal account, or a major credit card.


Name
Address 1
Address 2
City
State:
Zip
E-mail
APTA Membership Number


 





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