Fall 2021 Self-Care Share Registration
Thank you for your interest in the Fall 2021 Self-Care Share. Registration is open until the end of Thursday, September 2nd. After you submit this form, you will be contacted by email to set-up / confirm payment. Please email Jennifer at
with any questions.
What is your name?
Is this for you, or is this a gift for someone else? If a gift, please list the recipient's name here.
Are you registering for the full Fall 3-month share ($150) or the September 1-month trial share?
Full Fall 3-Month Share
September 1-Month Share
How will you be paying?
Will you be picking up your share, need it delivered locally, need it boxed for sending, or sent by mail to recipient?
Pick-Up at Sarah's home.
Delivered (Additional $10. Must be Blacksburg, Christiansburg or Radford for delivery service)
Boxed for sending (Additional $15)
Share shipped to someone in the U.S. (Additional $45)
What is your preferred email address to receive correspondences and mindfulness practice recordings? If this is a gift, please list gift recipient's email address here as well.
What is your address? If a gift, please include gift recipient's address here as well.
What is your phone number in case you must be contacted about your share? If a gift, please include gift recipient's phone number here as well.
Do you have any allergies / health concerns that we should be aware of in preparing your herbal share?
Any other questions / information you would like to share? If so, please share below.
Send me a copy of my responses.
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