(If you wish to cancel the contract, please complete and return this form).
Deutsche Gesellschaft für Homa-Therapie e.V.
I/we (*) hereby revoke the contract concluded by me/us (*)
for the purchase of the following goods (*)
Ordered on (*)/received on (*)
Name of the consumer(s)
Address of consumer(s)
Signature of consumer(s)
(only in the case of a paper communication)
___________ (*) Delete where inapplicable.