Conscious Connecting between Men and Women: Registration Form (one per person)
Welcome! Thank you for your interest to participate.
Please fill in one registration form per person. The information is confidential and helps us create a safe space, adapted to your needs.
We limit numbers in each gathering, and try to find a rough balance between men and women if possible. We will confirm your registration within a few days. Please do honour your commitment to attend once confirmed.
Thank you!

Questions: / 079 219 4407
Email address *
First Name *
Last Name *
Gender *
Phone number *
Dates you will attend *
What is your deep inner motivation to attend? Please reflect honestly on this question to help you prepare. *
Have you any previous experience of personal development around your inner masculine & feminine, conscious relating or sacred sexuality? *
Do you have any unprocessed emotional, mental, physical or sexual traumas that may require particular support ? (e.g. difficulty to know your boundaries, receive touch, express needs, acknowledge projections, or stay present with certain emotions)
Preferred language *
Any questions or themes you'd like answered? Or further information to share with us?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy