Remember Your Crown

Programme Registration Form

Please complete and return this form before the first session on Wed 27th May.

Name*
First Last
Email*
Date of Birth*
MM slash DD slash YYYY
Address*
City Country
What is calling you to join this programme?*
What shifts/changes would you like to experience by the end of the programme?*
Have you previously done any work with me? If so, please describe?*
What other programs have you attended for awakening the feminine or personal transformation?*
Do you have a regular spiritual practice (meditation, prayer, yoga) and if yes please describe?*
Do you have any medical conditions that I should know about or are you under the care of a mental health practitioner and please describe?*
How did you hear about me?
Is there anything else you feel you would like to share or I should know about?
By signing below you agree to the Kerry Magnus Conscious Living Policies:
- I understand that I am responsible for my own journey of self-growth and will get out what I put in.
- I am committed to my self-care and will reach out for support should I feel that I have been triggered in any way by this programme.
- I am responsible for asking for what I need and will reach out to Kerry should I need to.
- I respect the intimacy of the container that this programme and the other participants create and will respect the confidentiality of this space.
- I agree not to share the contents and material shared in this programme.
- I commit to follow through with any agreed payments (if a payment plan was chosen).
- I understand that no refunds will be granted for this programme.
- I agree to the Kerry Magnus Conscious Living terms and privacy policies.
Signature*
Name
Please print your name if the signature field does not work for you.
First Last
Date
Month
Day
Year
Thank you so much for taking the time to complete this form. I look forward to meeting you properly when we start the programme.
Comments
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