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Seminar registration

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Every attempt is made to offer this program as announced. Life Chiropractic College West reserves the right, however, to adjust program faculty, locations, dates, times and tuition to accommodate unanticipated occurrences, and to cancel due to insufficient enrollment. We will only notify advance registrants of any cancellation or program changes. Life West is not responsible for any expenses incurred by registrants due to adjustments or cancellations.  A $50 processing fee will be charged for refunds when a registrant provides written notice of cancellation at least one (1) business day prior to the seminar start date. Registration is nonrefundable if the program for which it applies is conducted as scheduled; however, registration credit may be given for attendance at a similar program at a later time or at another location, minus a $25 transfer fee.   

Complete a separate registration form for each person attending

Please register me for the following course (circle one):

X-Ray - New Frontiers in Whiplash Chiropractic Management of Upper Extremity Entrapment Syndromes X-Ray - Spinal Disorders
The Heat is On - Menopause and PMS Chiropractic Guide to Healthy Living
Practice Made Perfect Validating Chiropractic

Date of course:

Course location:

Name:

License number(s)

Address: 

Phone

City/State/Zip: 

Fax 

e-mail address:

Payment by:

Check/money order

(US funds, payable to Life Chiropractic College West)

Credit card #

Expires: 

Registrations with a credit card payment may be faxed to:

(510) 780-4518

Or mail this completed form with your payment to:

Department of Continuing Education

Life Chiropractic College West

25001 Industrial Blvd

Hayward, CA  94545