Shamanic Kink Introduction: Conscious Castle, Verlaine, Belgium. 20-21 September 2025 - Intention & Preparation Form
Thank you for taking the time to fill in this form. We use this form to get to know you and to support you in entering the weekend course powerfully. Please make sure to send over payment when filling in this form, otherwise we can't confirm your registration, and fill it out no later than 7 days after paying the training payment.

At any time feel free to contact Danny at theconsciouscastle@gmail.com if you have any doubts, questions, or a request to get in touch with either of the facilitators.

We are excited to get to know you and to be journeying with you in the Shamanic Kink Introduction Weekend.

Thank you!

Terra, Francesca & Danny

*The information submitted in this form stays confidential to the facilitators and organizer of this course only.
Sign in to Google to save your progress. Learn more
E-mail Address *
Your Preferred Name and Pronouns *
Full Legal Name
*
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Nationality/Place of Birth *
Current Place of Residence *
Active Whatsapp Phone Number
*
Emergency Contact Name, Relationship, Email and Phone Number
How did you hear about this course, or, who recommended it to you? Please list more than one if you heard about it from multiple sources.
Food Allergies or Dietary Restrictions

*
Required
Regarding the duration of this event there are three options. The fee for your chosen option needs to be paid to bank account number NL81INGB0005239763 in the name of D.L. Karijopawiro, with destription 'SKI'. *
Cancellation Policy:

- Further than 15 days of start date: a €150 admin fee is withheld.

- 30 days or closer before the training start date: loss of the full fee, or move your payment to another Shamanic Kink training with a €150 admin fee.

- 15 days or closer before training start date: loss of full fee.

*
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report