Registration Form

BioTouch Inc. does not and will not accept any State or Federal Financial Aid from any program.
All Students and models must be 18 of age and older.

**FOR ALL CLASSES, PLEASE WEAR CLOSED TOE SHOES**

Refresher Courses: All students may take a free refresher course within 1 year of their enrollment, including
any student not passing the procedures and performance tests. Proof of prior enrollment is required to register.

Payment Information:

Name (as you want it to appear on your certificate, please print clearly): _________________________________
Name of School (or Salon): ____________________________________________________________________
Home Address:______________________________________________________________________________
City: _________________________________________ State: ______________ Zip: _____________________
For all courses (except Lash) choose one:
 Initial: ________ I’m already registered to the California Health Department as a Body Art Practitioner (Must bring proof)
 Initial: ________ I am not registered but I will be working with a Live model. We will register you to the Health

Department as a Practitioner.

Please provide:

1. Non-refundable $67 Practitioner Health Department processing fee
2. ID photo
3. Your LA Country Approved Bloodborne Pathogen Certificate
4. Hep. B vaccination document or signed declination

 Initial: ________ I am not registered and I do not want to work with a Live model this session. (To receive certification,
you must demonstrate complete learning and skill on a Live model. You can bring a model on your
Free Refresher course within a year to complete your certificate requirements)
A 50% deposit is required to hold your seat for the course. All advanced deposits must include a signed copy of
the Enrollment Form. The remaining tuition balance will be due two weeks before the commencement of the
class.

A non-refundable registration fee of $180.00 applies to every new class enrollment for each student as part of
the tuition.