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Membership Type *	SOAR Rapid Relief Course on MP4 ($229.95) You will receive four MP4 video course data discs for loading into -- and viewing on -- your computer, iPod or other MP4 player Free online viewing until your discs arrive Free twenty minute session with Capt. Tom Free unlimited Group Phone Counseling Upgradable with full credit for this purchase to The Complete Relief Accelerated Course The SOAR Video Course, or The Guaranteed SOAR Video Program Your discs will be shipped immediately
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Choose a Password * Must be 4 or more characters
Confirm your password * Enter password again