The Enlightened Communication Workshop Enrollment Form

Registration Information: Please Read Carefully


A note about payment:

We can't yet accept credit cards, so you will need to mail us a check. (Make checks payable to Ray Hix.) You can copy this form to your editor, fill it out, and email it to me, or print it out and mail it with your check.

General Information:

Social greetings and completing registrations will start at 9:15 A.M. and finish at 9:30 A.M. on Saturday. Class will begin promptly at 9:30 A.M., so please arrive on time. We will end Saturday and Sunday approximately 6 P.M., depending on the flow of your group.

Wear comfortable clothing. Please bring a notebook and pen to record the many insights and distinctions you will want to recreate. You may want to begin by listing your goals for the course.


To Register:
Investment is $200, or $350 for a couple.
Please make check or money order payable to:

Ray Hix

P.O. Box 8448
Berkeley, CA 94707

There is a $25 handling fee for cancellations or transfers to another seminar.

Seating is limited. Please register as early as possible!


Please fill in the following information and sign the waiver below.
Are there any goals you have for this course you would like us to energize? Tell us anything about yourself you would like us to know. All information is confidential. You can send an extra sheet if you prefer. Please print clearly and return ASAP with either full payment or your deposit. Thank you.

___I am enrolling in the Enlightened Communication Workshop beginning _______________________(date).

Please print clearly and return as soon as possible with your payment or deposit. Thank you.

___I am responding by at least 2 weeks early. Please notify me of any current bonus incentives for early enrollment.

___Enclosed is my full payment of $250

___Enclosed is $400 for me & my partner

___I am enclosing a deposit of $100.

I will pay the balance by ____________________

___My partner paid for both of us

My partner's name is: ___________________

___Enclosed is $125 to review
Make check payable to Ray Hix.

Name: ______________________________________

Address: ____________________________________

City: _____________________

Zip: _____________

Day Phone: ___________________

Eve Phone: ___________________


Please read and sign the waiver below:

We will be exploring expanded states of consciousness during this course, including guided meditations and energy awareness techniques. Some of the states of consciousness, self-examination and personal insights can be very stimulating, exciting, or create emotional releases. While the techniques and energies we'll be working with are themselves very safe, they tend to facilitate breakthroughs in people's lives. Whenever you commit to a breakthrough in any area, you can expect to come up against whatever it is that's been keeping you from that breakthrough up until now. That sometimes looks and feels like breakdown.
This course will not bring you any problem, symptom, or condition that you would not have eventually encountered on your own. However, it will bring consciousness to some areas of your life in which you may have been avoiding responsibility.

If you have a mental or physical condition that would make participation unwise in light of this knowledge, we advise you to reconsider participation at this time. Please realize we do not offer this course as a substitute for any psychotherapy or medical treatment you may require. We know of no case or have any knowledge of any case on record where an individual has ever been harmed by attending one of our seminars. We do know of hundreds of cases where people have benefited in many ways from using these techniques. It is necessary as a general practice to have everyone taking part in the courses sign the waiver.

Waiver:: I have read and understood the above. I am of legal age, and in consideration of my participation in Ray Hix's Enlightened Communication Workshop, I for myself, my executors, administrators and assignees, do hereby release and discharge Ray Hix and any of his employees, assistants, counselors, or support team, for all claims of damages, demands, actions, whatsoever in any manner arising from or growing out of my participation in the course.

Signature__________________________________

Age________

Date_________________

Thank you for enrolling in the workshop. I look forward to our time together.


To return to the Flyer:
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  • You can
    Or Phone him at (510) 525-7470

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