Registration via Purchase Order

ChildLight Education Company LLC
P.O. Box 247
Exeter, NH 03833

School / Organization Information*

School / Organization Name

Street Address

CityState / Province

Postal / Zip CodeCountry

Billing address, if different from above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Billing Contact*

First NameLast Name

Billing Contact Email Address*

Billing Contact Phone Number*

Area CodePhone Number

Please select training you wish to attend.*

Please select start date of the training.*

MonthDayYear

City and State of Training (or "Virtual") Location*

1. Name*

Position / Grade*

Cell Phone Number*

Email Address*

2. Name

Position / Grade

Cell Phone Number

Email Address

3. Name

Position / Grade

Cell Phone Number

Email Address

4. Name

Position / Grade

Cell Phone Number

Email Address

5. Name

Position / Grade

Cell Phone Number

Email Address

example@example.com

6. Name

Position / Grade

Cell Phone Number

Email Address

example@example.com

7. Name

Position / Grade

Cell Phone Number

Email Address

8. Name

Position / Grade

Cell Phone Number

Email Address

example@example.com

9. Name

Position / Grade

Cell Phone Number

Email Address

example@example.com

10. Name

Position / Grade

Cell Phone Number

Email Address

example@example.com

If you need to register additional participants, please email lstevens@childlightyoga.com and include the name of your organization + the training you are registering for in the email.

Please check box below if you will be paying by Credit Card. Invoice will be submitted via email to Billing Contact above to be paid online upon receipt of invoice.

Credit Card

If the registrant is part of the ChildLight 95hr RCYT Program, please enter their 95hr promo code here or any other applicable promo code (only one may be used at a time):

Purchase Order Terms

If registering with a purchase order, please provide the purchase order number and upload your purchase order below as required.

The billing contact provided will be emailed an invoice upon approval of the purchase order within 3 business days.

For all multi-day training purchase order registrations, please add a $25 processing fee for 1-2 individuals or $50 processing fee for 3 or more. For all one-day workshops, online or on location, please add a $10 processing fee for 1-2 individuals or $25 processing fee for 3 or more.

Payment is due no later than two weeks following the date of service.

Purchase Order Terms Agreement

I have read and agreed to the Purchase Order Terms outlined above. PLEASE NOTE that the purchase order processing fee must be included on your purchase order in order to be accepted and processed.

Purchase Order No.

Upload Purchase Order (Required)

Upload a File

How did you hear about us?*

If you are registering another person for a ChildLight workshop or training, by clicking the box below you are agreeing to our terms & conditions on the registrant's behalf.

Registration via a Purchase Order