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Registration Form
 
Please complete registration below to sign up for any of our services.
This will allow you priority when space is limited.
 
First Name
Last Name
Date of Birth
Gender
Male
Female
Email Address
Phone
Address 1
Address 2
City
State
Zip Code
Type of Service
Group/SeminarTitle (If registering for a group or seminar)
If you are registering for group, class, or event, please select the date of the event you wish you attend.
Additional Comments or Inquires
Payment Type
 
Please contact us directly at (831) 402-1799 to ensure that space is available,
and that your payment and registration is complete.
 
Thank you for registering with LWC. 
 
Lighthouse Wellness Center of Monterey, CA
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536 Abrego Street
Monterey , CA , 93940 USA
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Phone 8314021799