REGISTRATION FORM

THRIVE -CORE MC5

6 week Program: Tools and guidance to fuel optimal personal wellness.

647-444-9457
susan@familyhelponline.ca

YAY!!! I am excited that you are ready to THRIVE with CORE MC5!

Check with your personal insurance to see if your registration fees can be covered.

Refunds can be provided within 7 days of program start up. All requests for refund must be done in writing.

Susan

First/Last Name

FACEBOOK Profile NAME

Email address

Telephone number

If error message, please include phone number in notes area below.

Which Package have you decided on?

BETA TESTER

I agree to provide feedback about user experience and a testimonial/review of program.

BACKSTAGE PASS

$150 I want to learn more but do not want to be a Beta Tester

WAITLIST

Please notify me when you are ready for official launch. I understand that the current offers will not be available at that time.

What do you hope to gain most from this program?

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Susan O'Quinn MSW, RSW

THRIVE CORE MC5

Currently in development and testing phase. Susan brings her personal and 25+ year professional expertise together to help you learn more about fuelling optimal mental health and wellness. Craft your personal recipe for optimizing your best self and begin to implement simple steps to reduce risk for mental health difficulties.

www.familyhelponline.ca