REGISTER for Wild Embodiment TRUE NORTH

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JOIN WILD EMBODIMENT:
True North

Please fill out the form & pay to register.

First Name

Last Name

Gender pronouns:

What is your intention for joining Wild Embodiment: True North

Which track are you signing up for?

THURSDAYS Oct 17-Jan 23 (NO class Oct 31, 11/28 or 12/26) 3-5pm PST

FRIDAYS Oct 18 - Jan 24 (NO class 11/29 or 12/27) 1-3pm PST

Please describe an overview of your prior experiences with any kind of somatic (body based) healing?

What resources do you currently have to support your healing process?

Is there anything we should know about your physical, emotional or mental needs that would be supportive?

Do you anticipate needing to miss any of the sessions? If yes, please share the dates:

Do you want to set up a payment plan? We offer 3, 6 and 12 month options.

Yes

Scholarships are limited. Do you require a scholarship in order to participate?

Yes

Maybe

How did you hear about us?

Word of mouth

Social media

E-news

Other

If word of mouth, please tell us who referred you so we can thank them :)

I consent to the terms of use for this program.View terms of use

Yes, I understand that I must make a deposit to be registered for this program (see checkout page).

Yes, I want to subscribe to your newsletter!

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