ISTA Level 1 - Registration Form
Welcome to the Spiritual Sexual Shamanic Experience (SSSex) Level 1 Training being held at Highden Temple, New Zealand, 8 April - 14 April 2019.

The first step of the journey begins with completing the following registration form.

Completing this form will support you to get the most out of the journey. Please answer all questions so we can best cater to you and your needs.

All information provided is confidential and will only be shared between ISTA Organisers & Faculty.

Thank you for taking the time and we look forward to welcoming you to Highden.

In Love & Service,

Yvette Daniel & Regan Pryor

Email address *
First name *
Your answer
Last name *
Your answer
Contact phone number: *
Your answer
Facebook name *
Your answer
Street address (including suburb, post code, city & country) *
Your answer
Date of birth *
These following two questions are optional. If provided, we may prepare an astrology chart or a human design reading prior to your attendance.
Time of birth (if known)
Place of Birth (including country and city)
Your answer
Gender *
Nationality: *
Your answer
Emergency contact name: *
Your answer
Emergency contact phone number: *
Your answer
The catering team are interested in providing optimum nutrition. You will be provided with 3 meals per day. The food is delicious, fresh, wholesome creative and Vegetarian.

All food is free of refined sugar, additives, colourings & preservatives.

Please let us know of any food restrictions we should know about *
We have 3 options available for accommodation. The Dorm, The Manor and Camping
Select your preferred option: *
Are you coming to the training with an intimate partner? *
If yes, who?
Your answer
Relationship Boundaries & Agreements
If you are currently in a relationship/partnership, we recommend that you agree upon your relationship boundaries before arriving to the training, regardless of whether your partner is attending the training with you or not.

These would include boundaries around intimacy, intimate touch, sexual engagement, safer sex practices etc.
ISTA field encourages transparency, open communication and authentic expression of desires with integrity.
Have you taken ISTA trainings before?
If so, please enter the names of previous trainings taken with the name of the lead and the country of training.
Your Answer *
Your answer
Please finish this sentence: “ If you really knew me, you would know that I have chosen to attend this training because…:
*For example, If you really knew me, you would know that I have chosen to attend this training because I crave something more meaningful than my 9-to-5 job and fulfilling my responsbilities as a mother, lover, daughter, medicine woman and counsellor. I have been going around in circles for the last few years, till I decided to put myself first, so
Your Answer *
Your answer
Please briefly outline any self development processes you have done *
Your answer
Are there any significant life events you feel it is important for us to know about (Deaths, illnesses, addictions, abuse...) ? *
Your answer
What experience do you have (if any) receiving your own sexual healing work? *
Your answer
The training includes some physically active components, such as dancing & full body movement. Please let us know if there is any physical movement difficulties. *
Your answer
Do you have any medical conditions/health issues/infections or take any medications that we should be aware of? *
Your answer
Please inform us if you have or have had any significant mental health challenges in your life.

Note any psychotic events or similar.

This information will remain confidential within the facilitator team and it is in order to take care of you.

Your Answer *
Your answer
1. I agree to breathe, to feel, to be present and to be authentic.
2. I agree to maintain confidentiality. This means not disclosing any individual’s identities, stories, and experiences. I am free to speak about my own experience in the training.
3. I agree to show up for class each day at the agreed upon time for the duration of the training.
4. I understand that everything that occurs during this training is part of the transformational process of the event.
5. I agree to request support, guidance, and help using clear direct requests when I desire it.
6. I agree to be coachable: I am open to feedback and direction from the facilitators.
7. I agree to take full responsibility for the nature of my experience.
8. This course is designed to awaken powerful emotional energies. I agree to use the tools, techniques and philosophies being taught to process these emotions.
9. I agree to refrain from drugs and alcohol during the training.
10.I agree to not gossip on the training about others, and to speak directly to any person I have an issue with. If someone attempts to gossip with me about someone else, I agree to support them to speak directly to the person concerned.
11. I agree to ask people if they want feedback before I give it to them, and at a time that is suitable for both of us.
12. I understand that this retreat explores sexuality. As adults (including facilitators) we agree to be responsible for our own sexual experiences and interactions with others. If I choose to act on my or others desires, I will use clear direct verbal communication and safe sex practices.
13. I agree to allow people to have their experience and not intervene unless they ask for support: ie not passing tissues or giving touch/hugs or advice that has not been requested.
14. If at any time I feel that the training is not appropriate for me or I wish to leave the training, I agree to bring my concerns directly to the course instructors.
15. I understand that if I break these agreements, I may be compromising the value I could receive from this training.
I have read and agree to the above text *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service