Event Registration

Name:
Address:
City:
State:
Zip:
Phone:
Email:
Program Title:
Session:
Dates and Time:
Fee:
Deposit:
Special Needs:

Do you need childcare?  If yes, age and number of children needing childcare

Please print this form and submit to:
The Harmony Wellness Center
456 N. Main Street
Oshkosh, WI  54901
(920) 230-4680

Make checks payable to: The Harmony Wellness Center