Thebroma Tree Shamanic Plant Spirit Initiation Booking Form

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Saturday 23rd November 10.30am - 7.30pm @ The Clophill Centre, Bedford.

Email *

YOUR DETAILS

All the information you provide is confidential and will not be shared with any third parties.

Full Name *

Email Address *

Phone Number *

What is your experience, if any, of shamanic or plant spirit energy work? This information helps us to tailor our time together. *

How did you hear about this event? *

WELLBEING

Do you have any dietary requirements? We will try to accommodate them where we can, if we are not able to we will give you a call/message and discuss. *

Do you have any allergies? *

Are you pregnant or trying to conceive? *

Yes

N/A

Are you taking any medications or supplements? (can answer 'prefer not to say'). *

I understand that my physical, emotional, mental, and spiritual wellbeing are my responsibility at all times and that attending the Thebroma Shamanic Plant Spirit Initiation is not a replacement for any medical/professional service or advice. *

Yes I understand

Required

EMERGENCY CONTACT DETAILS

Please provide details of who to contact in the case of an emergency.

Emergency Contact: Name *

Emergency Contact: Relationship to you (e.g. husband, wife, mum, etc) *

Emergency Contact: Phone Number *

Emergency Contact: Email address *

INVESTMENT

The investment for the Theobroma Tree Plant Spirit Initiation is £50. A non-refundable deposit of £50 is required to book your place. Payments can be made to The Shamanic Herbalist, HSBC, 40-45-08, 22578042 with reference Theobroma Clophill. Please send email confirmation once payment has been made.

Would you be interested in a work exchange place if one is available? (This means the investment amount will be lower in exchange for help with a few tasks at the end of the day). *

Yes

How will you make payment? (Please only choose other if you have agreed it with us in advance)
*

£50 non-refundable deposit - balance paid in full at time of booking

£50 non-refundable deposit - balance paid before or on Friday 24th October

Other:

THANKYOU :)

Thanks for taking the time to fill out this form. If you have any questions you can contact either or both of us.

Kim: kimrootsinnature@gmail.com

Suneet: theshamanicherbalist@hotmail.com

A copy of your responses will be emailed to the address you provided.

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