Register ICM – Greet The Day

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Helping make the experience of cancer treatment better.

Register for the Infusion Center Massage program

Use the form below to register for your upcoming class. Please fill out all fields and review the Learner Agreement & Liability Waiver before submitting your registration.

Full Name *

Certificate Name

If different from above, please fill out your name as you would like it on your class certificate.

Email Address *

Important please note: You will need to use the same email address you register for class with to sign into Google Classroom.

Phone Number *

Please fill out your 10 digit phone number, including the country code. Ex: +1 (000) 000-0000

Your Location *

If you live in the USA, please fill out the name of the city/state you live in; If you live outside of the USA, please fill out the name of the city/country you live in.

Which professional license(s) do you hold? Mark all that apply. *

Massage therapist
Esthetician
Cosmetologist/Nail Technician
RN/LCSW

If other professional license, please specify

Which glove size do you think will be the best fit for your hands? *

Small
Medium
Large
X-Large

Is there any additional information you would like to add? Or questions you want to ask?

Photo Release *

Yes, I consent and release my image and/or voice recording for use by Greet The Day.
No, I do not consent or release my image and/or voice recording for use by Greet The Day.

By participating in a GTD course, you are giving your consent to have your image and/or voice recorded for use by GTD for future publications, productions, and/or promotional purposes without compensation. Your full name will not be used in connection herewith without your consent. This material will be owned by GTD.

Acknowledgment of Understanding: Learner Agreement *

I have read and agree to the terms of the Learner Agreement.

Acknowledgment of Understanding: Liability Waiver *

I have read and agree to the terms of the Liability Waiver, including the Assumption of Risk and Indemnity Agreement Waiver.

Electronic Signature *

Please fill out with your full name. By signing your name electronically, you acknowledge to fully understanding the terms in both the Learner Agreement and Liability Waiver, to signing the Learner Agreement and Liability Waiver freely and voluntarily, and intend by your electronic signature to be a complete and unconditional release of all liability to the greatest extent by law.

Name