Sponsorship Application Form – Energetics Explained

First name:

Last name:

Phone number:

Email address:

Confirm email address:

Preferred date:

Are you available for the group preparation and integration sessions?

The group sessions are held online at 7pm (UK time). The preparation sessions are held every Thursday of the month before the retreat and the integration sessions are held every Sunday of the month after the retreat

Occupation:

Passport number:

Dietary requirements:

Please specify any medication you are currently taking:

Please explain why you would like to join the retreat:

Max 200 words

Please explain why you should be considered for a sponsored place:

Max 200 words

Do you have any previous experience working with plant medicines or shamanic practices? If so, please provide details:

Max 100 words

Please describe your current physical and mental health and provide any family history which may be relevant:

Max 200 words

If you are unsuccessful this time round, we will automatically reconsider your application for future retreats this year. If there are any retreats you are unavailable for and/or would not like to be considered for, please list these below.

Max 200 words

I acknowledge and agree that my booking will be subject to the Terms and Conditions. For details of how we use your data please see our Privacy Policy

Thank you for booking! You will receive a confirmation email with next steps.

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