Participant Registration Information - Waiting List ISTA SSSEx UK 8-14th November 2021
Welcome to the Spiritual Sexual Shamanic Experience Level 1 Training.

As our journey approaches many of you will be experiencing a range of feelings.  Please take the time to fill in this form and return it to us before the training as it will support you to get the most out of your journey by clarifying your deepest motivations.

Please complete all of the details in the form below
Sign in to Google to save your progress. Learn more
Email *
Name *
Write down your full name. For example, Carlita De Brena
Address *
For example, Garden of Eden, Devon, UK.
Phone Number *
Write down your full name. For example, Carla De Bruyne, 220 Green Manor Drive, 31452, New Zealand.
Emergency/Next of Kin Name & Phone Information *
For example - Connor Green, 144 Blue Drive, UK. + 44 - 7546320135
Gender? *
What pronoun do you prefer to be used with you name? for example - he/she/it
Email Address *
Enter your email address. For example,
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
What, if any, experience of giving and/or receiving sexual healing work have you had ? *
(Please note this is not a requirement for the training )
Please briefly outline any other self development processes you have done. *
Are there any significant life events you feel it is important for us to know about (Deaths, illnesses, addictions, abuse...) ? *
Do you have any medical conditions or take any medications that we should be aware of? *
Please inform us if you have or have had any significant mental health challenges in your life, include anything of note we ask this in order to take care of you. Please particularly note any psychotic events or similar. This information will remain confidential within the facilitator team. *
Have you taken the SSSEx training before? *
If so, please enter the names of previous trainings taken with the name of the lead and the country of training.
Are you attending this training with a partner? *
Accommodation - You will be sleeping in mixed or same gender shared bedrooms within the lovely houses at the Duvale Retreat that is included in the cost of the event. Note - A very limited number of private rooms rooms may be available for individuals or couples (partners not necessarily friends requesting to stay together) at an additional surcharge of 250 GBP for the week. Confirmation of allocation of private rooms and the associated surcharge cost will be made nearer to the training beginning. Do note that an application for a private room does not guarantee allocation of a private room - Thank you for your understanding *
Any specific accommodation requests? Please Note - While we will do our best to consider your request, it does not guarantee that we will be able to honor your request. Thank you for your understanding *
Our chef is interested in providing you with the optimum nutrition. Any special dietary requirements? For example, serious allergies, or glucose-free, lactose-free, or vegeterian options? *
Healthy, nutritious vegeterian food with lactose-free, gluten-free, and vegan options can be made available to support the work that we are doing. Wherever possible, we strive to use the most natural ingredients available, with an emphasis on local, sustainable & organic sourcing.
Any other dietary requirements? *
Relationship boundaries agreements - If you are currently in a relationship/partnership we strongly 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. *
If so, please enter the names of previous trainings taken with the name of the lead and the country of training.
Any other special needs? eg mobility ? *
How did you hear about this training? *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy