Flora Interspectra Registration
Please fill out the entire application.

Registration Exchange is due upon application. We will send you information on how to send payment.

If the class you signed up for becomes full- we will add you to the waitlist in the order you submit your application.

Once you have filled out the application and pressed "SUBMIT" -- We will email you a confirmation notice and payment info within 1 week.

Full Payment Refund only- 1 month before course or you can find someone else to replace your space.
No other refunds will be given if you cancel after then. You may always use your payment/deposit for credit for future classes or one-one healing sessions.

Thank You,

Flora Interspectra Team

Class you are applying for *
FULL NAME First, Last *
Your answer
Email Address *
Your answer
Phone Number # *
Your answer
Date of Birth *
Emergency Contact Info Name, Relationship, Phone # *
Your answer
Do you have any medical or accessibility needs that we need to know? *
Your answer
For the purposes of creating a safe space for the group, in what ways do you self-identify that you'd like to specifically and explicitly let us know?
Your answer
What is your background, if any in herbalism and/or natural-dyeing?
Your answer
For a portion of certain class/es we will be cooking/eating- do you have any know food/plant allergies or food restrictions/needs? Please list, if so.
Your answer
Anything else we should know about you?
Your answer
How did you hear about the class?
Any questions for us?
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy