Registration Form  |  Filipinx Food as Medicine -                      5 week Autumn Healing Circle
Please thoroughly read all the info at www.kaidelgadopfeifer.com/autumn2024 before filling out this entire form. I will email you after 2-3 days of you submitting this form and your payment (payment in last question), to confirm that you are signed up for the class. Both this registration form and sending your sliding scale offering must be complete to guarantee your space in the course. 

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Filipinx Food as Medicine - 5 Week Autumn Healing Circle
Taught by Kai Delgado-Pfeifer | IG @lolas.apo
5 Live Circles on Sundays: October 13, 20, + 27 & November 3 + 10
9am-12pm San Francisco Time     |     12pm-3pm New York Time     |   6pm-9pm CEST
Please be mindful that there is European Daylight Savings on October 27 and USA Daylight Savings on November 3. As the majority of class participants come from the US, folks in Europe will need to account for the hour (+/-) adjustment on both changes.

Registration Closes Wednesday October 9, 2024
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Email *
Did you read all the course information at www.kaidelgadopfeifer.com/autumn2024? 
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Due to the intimate nature and overall learning arc of our journey, participants must prepare to participate fully in at least 4 of 5 of our live sessions (first session on 10/13 is required). When arriving, please remain present for the majority of gathering time. Exceptions will be made for emergencies & sickness.

Are you able to meet this request? If no, we kindly ask that you register for our email list in order to get plugged in for future offerings. Sign up at www.kaidelgadopfeifer.com/stay-connected

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Full name *
Phone Number *
What is your Racial/ethnic/cultural background? A kind reminder that this space is for BIPOC only (including mixed race folks of European descent lineage). We gently ask our kin who come exclusively from european descent lineage to seek other culturally appropriate spaces supportive to your healing & decolonization. *
Where are you geographically located? Please include your Zip Code (example-- "Oakland California, 94606"  *
Gender Pronouns. If this is unfamiliar to you, we encourage you to read more here: https://www.npr.org/2021/06/02/996319297/gender-identity-pronouns-expression-guide-lgbtq *
What calls you to Gather with our circle? What are your learning intentions? Please offer at least 3 sentences here to help us understand clearly why you're arriving. *
What is your background or interest, if any, in food, herbalism, ancestral healing, environmental/ecological work, or movement building/community organizing? It's ok if this course is a starting point-- this space is for anyone at any stage of their journey. If this is a starting point, what knowledge do you hope to deepen into? *
Do you have any allergies or dietary restrictions I should be aware of when preparing our recipes/cooking lists?
Please select your sliding scale contribution. Information for how to send is found in the next question. Please submit your offering prior to submission of this form. *
Required
Are you requesting a payment plan? If yes, please email lolasapofood@gmail.com with your request and proposed timeline of payments. A deposit of at least $100 is required to hold your space in the course. All payment plans must be complete by October 31. *
Please choose your contribution via Venmo cashapp or Paypal. Friends and family transactions only please. Please do not submit this form until you have sent your exchange/offering.
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Any other Questions or Concerns?
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