Application Form

Embodying Spirit • Salt spring Island, B.c. • Canada

October 15-19, 2019
 

Please submit a deposit and fill out the application below

 

Take me back to 'Details of this Retreat'


Embodying Spirit • Salt Spring Island • October 15-19, 2019

Name *
Name
Address *
Address
Phone *
Phone
Accommodation *
Please choose Shared or Private Accommodation ($170 surcharge)
Deposit / Payment Completed *
Are you on any prescription or other medication? *
Do you have a history of mental illness?
Where did you hear about us? *
Please list all that apply
Terms & Conditions of My Registration *
http://www.lineageoflight.com/cancellation-policy/