Interested in Claiming Your Sacred Sexual Shamanic Self ?
Awesome! Please read about this 3 month leadership & sexual empowerment program at: www.LeslieBlackburn.com/ClaimingYourSacredSexualShamanicSelf before answering these questions.
Email address *
Name *
First and last name
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Phone number *
Your answer
Where are you based? *
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What inspires you to work together? *
Your answer
What is your background in or experience with yoga, mindful movement practices (ex. contact improv, dance, qigong, authentic movement, continuum), meditation, tantra, shamanism, healing modalities, energy awareness, bodywork? *
Your answer
What is your spiritual and/or religious background? *
Your answer
What is your vision for yourself in the next year? Seeing yourself in the future how does your life look different as the result of our work together? *
Your answer
What inspires you about Sacred Sexuality? *
Your answer
What is your current teaching/leading/facilitation experience (with groups and/or individuals)? *
Your answer
What is getting in the way of your vision above? What inspires you to seek this program? *
Your answer
Are you ready to make a financial investment in this part of your life? Options below are for early bird with reg by Jan 21, 2019. *
Payment options include $5000 in installments of your choosing with completion by Feb 11, 2019 OR $4500 one time payment.
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Please confirm your availability for full participation in the retreat and calls. All video calls are Tuesdays, 4 - 5:30 pm pacific/7 - 8:30 pm eastern. *
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Have we worked together before? If not, how did you hear about "Claiming Your Sacred Sexual Shamanic Self"?  *
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