If you are a human and are seeing this field, please leave it blank. Please fill in the following form to register for our upcoming Understanding Your Dreams group. Please note that registration ends on Wednesday, March 15th and payment needs to be received by this day as well. This group will run on: Wednesdays March 22, 29, April 5, 12, 2017 from 7:00 pm – 8:30 pm Please feel free to contact the office you have any further questions. Once we have your completed registration form, our office will follow up in regards to payment. First Name Last Name Address City Province Postal Code Email Phone May we leave a confidential voicemail? Yes No Would you like us to send you an email or text message reminder 24 hours before the appointment EmailText MessageBothNeither How did you hear about the Dream Group? Facebook Twitter Google Other Other: Can we contact you in the future to make you aware of upcoming programs and general information regarding our services? Yes, Please. No, Thank You.