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Registration - FORM                                        
It's Time For Healing! 
WELLNESS & HOLISTIC workshops/Retreats/1:1 Sessions
CONTACT: 
kymberlykind@itstimeforhealing.Life or 512.953.7237
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FIRST & LAST NAME  *
EMAIL  *
PHONE NUMBER *
EMERGY CONTACT: Full Name, Phone Number, Email  *
BEST METHOD OF CONTACT?
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D.O.B *
Are you sensitive to sound ?
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Are you sensitive to touch ?
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Are you sensitive to fragrance ? 
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Please list any Allergies ?
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Your Past Medical History or current  *
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Do you have a particular concern or focus for your session ?
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Client Acknowledgment & Consent

I understand that this session is intended to support emotional & energetic healing and does not replace medical or psychological care. The practitioner does not diagnose, treat, or prescribe medications, nor interfere with the care of licensed professionals.

***Clicking this check box acts as your electronic signature to this agreement***
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Client Acknowledgment & Consent Disclaimer

Sacred Family Constellation is a powerful experiential process that can bring unconscious family, relational, and emotional patterns into awareness. For some, this experience may feel deeply moving or emotionally intense, while for others it may feel gentle, subtle, or simply offer new perspectives. Every experience is valid.

Everyone is at a different stage of their healing journey. There is no right or wrong way to participate, and there is never any expectation to share more than feels safe. You are encouraged to honor your own pace and listen to your body throughout the workshop.

This workshop is intended to support self-awareness, personal growth, and nervous system regulation. You are always welcome to pause, step outside, or simply observe.

Our intention is to create a compassionate, confidential, and non-judgmental space where everyone is treated with dignity and respect. By participating today, you acknowledge that healing is a personal process, and each person's experience will be unique.

***Clicking this check box acts as your electronic signature to this agreement***
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Required
Integrity: 
Our workshops, events, and immersion retreats are intentionally created as safe & sacred containers and may involve deeply vulnerable healing experiences for many participants. To preserve the integrity, safety, and sacredness of these spaces, all events are sober and non-sexual environments. The use of alcohol or recreational drugs is not permitted during any Sacred Heart Community gathering/ sessions and all interactions are expected to remain respectful, appropriate, and aligned with the healing purpose of the container.  

***Clicking this check box acts as your electronic signature to this agreement***
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Required

WORKSHOPS & IMMERSIONS ONLY

By submitting this form, I acknowledge and grant permission for photographs, video, and audio recordings of me to be captured and used by the practitioner, event organizers for promotional, educational, and marketing purposes. This includes use on websites, social media, printed materials, and other platforms.

***I can opt out by notifying the event organizer prior to or upon arrival***

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