Scalp Micropigmentation Booking

Name
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Contact Number*
Email*
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Please let us know of any medical condition you have which may prevent you from taking this course, or that we have to be aware of in case of emergency:
Beginners 4 Day Scalp Micropigmentation Course
- Deposit - £700
Advanced 3 Day Scalp Micropigmentation Course
- Deposit - £700
Next of Kin (Name & Contact Number)
I have read and accept the Privacy Policy and consent to Theresa Wild Training & Events LTD contacting me about my enquiry. (required)*
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I consent to Theresa Wild Training & Events LTD contacting me with future updates
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