Training Course Booking Form 2015 K-T Training (Admin) 123 Ermin Street Swindon SN3 4NH T: E:

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1 For Office Use Only: Date Booked: Course Booked: Paid: Date Paid: Training Course Booking Form 2015 K-T Training (Admin) 123 Ermin Street Swindon SN3 4NH T: E: GDC/GMC/NMC Num Check: Please complete this booking form Personal Information: Title: First Name (s): Surname: and return to K-T Training via or by post. Course Booked: Date: GMC/GDC/NMC (or International equivalent) registration number: Current Specialty: Address Line 1: Address Line 2: City/Town: County: Postcode: Telephone No: Mobile No: Address: Please advise where you heard about us: T: W: cannot accept responsibility for any medical or legal problems arising as a result of the use of these

2 We are currently offering a 10% discount when booking 2 introduction courses (example: Botox and Dermal Fillers courses = 1404 including VAT) January 2015 Botox Saturday 24-Jan Harley Street Dermal Fillers Sunday 25-Jan Harley Street February 2015 Botox Saturday 07-Feb Swindon Dermal Fillers Sunday 08-Feb Swindon Chemical Peel ½ day course Saturday 14-Feb High Wycombe Dermaroller ½ day course Saturday 14-Feb High Wycombe Tear Trough & Nose Correction Saturday 14-Feb High Wycombe Advanced Botox and Dermal Filler Sunday 15-Feb High Wycombe Liquid Face Lift (Voluma) Sunday 15-Feb High Wycombe Botox Saturday 21-Feb Harley Street Dermal Fillers Sunday 22-Feb Harley Street March 2015 Botox Saturday 07-Mar Swindon Dermal Fillers Sunday 08-Mar Swindon Chemical Peel ½ day course Saturday 14-Mar High Wycombe Dermaroller ½ day course Saturday 14-Mar High Wycombe Mesotherapy Saturday 14-Mar High Wycombe Advanced Botox & Dermal Filler Sunday 15-Mar High Wycombe Lip Master Class Sunday 15-Mar High Wycombe Botox Saturday 21-Mar Harley Street Dermal Fillers Sunday 22-Mar Harley Street April 2015 Botox Saturday 11-Apr Swindon Dermal Fillers Sunday 12-Apr Swindon Chemical Peel ½ day course Saturday 18-Apr High Wycombe Dermaroller ½ day course Saturday 18-Apr High Wycombe Tear Trough & Nose Correction Saturday 18-Apr High Wycombe Advanced Botox & Dermal Filler Sunday 19-Apr High Wycombe Liquid Face Lift (Voluma) Sunday 19-Apr High Wycombe Botox Saturday 25-Apr Harley Street Dermal Fillers Sunday 26-Apr Harley Street cannot accept responsibility for any medical or legal problems arising as a result of the use of these

3 May 2015 Botox Saturday 09-May Swindon Dermal Fillers Sunday 10-May Swindon Botox Saturday 30-May Harley Street Dermal Fillers Sunday 31--May Harley Street June 2015 Botox Saturday 13-Jun Swindon Dermal Fillers Sunday 14-Jun Swindon Chemical Peel ½ day course Saturday 20-Jun High Wycombe Dermaroller ½ day course Saturday 20-Jun High Wycombe Lip Master Class Saturday 20-Jun High Wycombe Advanced Botox & Dermal Filler Sunday 21-Jun High Wycombe Liquid Face Lift (Voluma) Sunday 21-Jun High Wycombe Botox Saturday 27-Jun Harley Street Dermal Fillers Sunday 28-Jun Harley Street July 2015 Botox Saturday 11-Jul Swindon Dermal Filler Sunday 12-Jul Swindon Botox Saturday 25-Jul Harley Street Dermal Fillers Sunday 26-Jul Harley Street August 2015 Botox Saturday 08-Aug Swindon Dermal Fillers Sunday 09-Aug Swindon Botox Saturday 22-Aug Harley Street Dermal Fillers Sunday 23-Aug Harley Street September 2015 Botox Saturday 12-Sept Swindon Dermal Fillers Sunday 13-Sept Swindon Chemical Peels ½ day course Saturday 19-Sept High Wycombe Dermaroller ½ day course Saturday 19-Sept High Wycombe Mesotherapy Saturday 19-Sept High Wycombe Lip Master Class Saturday 19-Sept High Wycombe Advanced Botox & Dermal Filler Sunday 20-Sept High Wycombe Liquid Face Lift (Voluma) Sunday 20-Sept High Wycombe Botox Saturday 26-Sept Harley Street Dermal Fillers Sunday 27-Sept Harley Street cannot accept responsibility for any medical or legal problems arising as a result of the use of these

4 October 2015 Botox Saturday 10-Oct Swindon Dermal Fillers Sunday 11-Oct Swindon Botox Saturday 24-Oct Harley Street Dermal Fillers Sunday 25-Oct Harley Street November 2015 Botox Saturday 07-Nov Swindon Dermal Fillers Sunday 08-Nov Swindon Chemical Peels ½ day course Saturday 14-Nov High Wycombe Dermaroller Saturday 14-Nov High Wycombe Lip Master Class Saturday 14-Nov High Wycombe Advanced Botox & Dermal Filler Sunday 15-Nov High Wycombe Liquid Face Lift (Voluma) Sunday 15-Nov High Wycombe Botox Saturday 21-Nov Harley Street Dermal Fillers Sunday 22-Nov Harley Street December 2015 Botox Saturday 05-Dec Swindon Dermal Filler Sunday 06-Dec Swindon Due to demand we will schedule extra dates for some courses. We do occasionally have late cancellations and our policy is to try and fill the place, if a course is FULL we do operate a waitlist for last minute bookings. Course dates, trainers and prices are subject to change without prior notification. cannot accept responsibility for any medical or legal problems arising as a result of the use of these

5 TERMS & CONDITIONS Payment & Terms: Payment for all courses must be received A MINIMUM OF 21 DAYS prior to course start date. Please note that your course reservation is not complete until Evaluation Booking form has been returned to us. No pre-course material or confirmation will be sent until full payment is received. Payment of course fees can be made by cheque or credit or debit card. Please make cheques payable to K-T TRAINING LTD. Cancellations: A 100% Refund will be granted if cancelling 21+ Days prior to course date. A 75% Refund will be granted if cancelling 14+ Days Prior to course date. No refund issued for less than 7 Days notice prior to course date. A 4% administration charge is applied for all refunds. If you wish to alter your course date you may do so without charge up to 3 days prior to course Disruptive or Unsafe Behaviour: provides group courses that require all of our members to respect each other in order to learn. Any candidate found to disrupt the lecture and the training environment will be asked to leave and any refund may or may not be fulfilled upon the discretion of the owners. If our trainers, staff members, delegates or models feel unsafe as a result of a delegate, that individual will be asked to leave immediately and their funds will not be refunded. I would like to make payment by (please circle): Cheque / Credit or Debit Card These courses are only available to Nurses/Midwives with valid NMC numbers, Doctors with valid GMC numbers Dental professionals with valid GDC numbers. To train and practice medical aesthetics in the UK you need to be registered with the relevant UK medical governing bodies. International Doctors must be registered with the equivalent governing bodies in the country were they practice. Please note these are the minimum requirements for all of our current medical aesthetic courses. By sending in this booking form you are agreeing to the terms & conditions stated above. cannot accept responsibility for any medical or legal problems arising as a result of the use of these

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