ILLUMINA Registration
I am so glad that you've landed here! Illumina is going to be more than just learning; I hope to build an active and welcoming community for women. Thank you for being here. 
This form will serve as your registration for Illumina. Please fill in to sign up. 
You will then receive the invoice via email.
After that, you can look forward to a welcome email a few days before we begin!
We begin the months cycle (theme) on the first Monday of each month.

Sign in to Google to save your progress. Learn more
Email *
Please provide your name and address *
We will have a group on Facebook to interact in. Are you on Facebook? If so, please list your name the way I can find you on Facebook. (I will also be sending the link to sign up via email.) *
We will have meetings/gatherings on Zoom twice a month. Community connection is an important aspect of this group. I will try my best to schedule these during times when most of you can join. Please provide three options for days/times that would work best for you to participate. (I am leaning toward evenings on weekdays or early morning on a Saturday or Sunday.) *
Please share with me why you decided to join us. What are you hoping to gain? What are you looking forward to learning or expanding your knowledge of? *
Agreement & Rules:
I understand that this group is a safe space. I agree to be courteous, respectful and considerate to all others in the group. 
I understand that this is a membership/subscription and I am agreeing to 3 payments, one payment per month, $44 each time. Membership per three month period cannot be canceled and cannot be transferred to someone else.

I understand that I am encouraged and invited to participate fully in the group, engaging with others, posting, and replying to others posts, as I feel comfortable.
I understand that everything that we share within this group is private and I agree to respect the privacy of all participants and never disclose personal or private information shared in our group.
I understand that this group is facilitated by Maralis Self, owner of Empowered Energy, and will make no attempt to gain clients or customers for my own gain, from this group.
I understand that all content provided in this program is the property of Maralis Self/Empowered Energy and will not copy or distribute any of the contents.
I understand that any violation of the agreement or rules will result in dismissal from the group.

*PLEASE STATE YOUR AGREEMENT AND UNDERSTANDING BY TYPING YOUR NAME AND DATE BELOW. THIS WILL SERVE AS YOUR SIGNATURE.
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Participation in this program is a commitment to yourself. It is a promise to show up for YOURSELF. It is an acknowledgement of your worth, your ability and your potential to expand, evolve and ascend.
I am here with my heart at the forefront, FOR YOU, and I want YOU to show up for YOU the same way. 
Are you ready and willing to show up for yourself?
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Welcome to Illumina! Use the section below to add any questions or comments that you might have.
Thank you for being a part of this amazing environment! I cannot wait to share time and space with you!
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