Workshop Registration Form

 

For the Celtic Heaven School only, please include a one to two page description of the basic struggles of your life and your spiritual path, so far.

Email all forms to: info@CelticHeaven.com

 

 

Name  _________________________________________Phone   _____________________________________________________________

 

Address   ___________________________________________________________________________________________________________

Email   _____________________________________________________________________________________  Gender  ________________

           

Allergies   __________________________________________________________________________________________________________

 

Strong food dislikes (not too picky, please)  _______________________________________________________________________________

 

Medical conditions and medications _____________________________________________________________________________________

 

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Psychiatric conditions and medications   _________________________________________________________________________________

 

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Physical handicaps, such as difficulty hearing, cannot sit on floor easily, etc.

 

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I have____ years experience with energy work. What type?___________________________________________________________________

 

What I hope to get out of this workshop__________________________________________________________________________________

 

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I give permission for my address, phone, and email to be put on a list and given to all participants. Yes____     No____