Soul Journey: Loyal Soldier Registration Form
Welcome! Please fill out this form as the next step to register for the Loyal Soldier Intensive.
The dates are: 2 daylong retreats: March 7 and June 7, 10:00-5:00,
3 evening meetings: February 20, April 2, May 7th, 6:30-8:30 p.m.
COST: $700-$1,250 Sliding Scale - see below for details
Name: *
Phone Number *
E-mail: *
What are your intentions in taking this soul journey?   *
What are the main patterns in your life that are stuck or no longer serving you? *
This work can bring up intense emotions, life changes, and unexpected triggers. We are each available to process some of what arises, and we also want to know what you already have in place to support you as you go into this intensive? *
Do you have any specific needs of which you would like us to be aware? (Scent-sensitivity, prefer a chair, sight or hearing needs, allergies, etc.)  
Please share any food allergies, preferences, or other dietary information (program includes two retreats with lunch): *
Emergency Contact Information: (please include name and phone number): *
Payment Options: Venmo: @Tracy-Rich-2 or send check to Tracy Rich, PO Box 302141, JP, MA 02130 *
Required
What will your Program Payment be (based on above sliding scale):
Payment Plan Options:
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Let us know if you would like to make a donation to our scholarship fund and indicate the amount:
Add any questions or information that would be helpful to share at this time:
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