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The Elder Within
August 21 to 25, 2024
Wednesday, 7 pm to Sunday, 1 pm
Contact us at (360) 320-5343 or
nwsoulquest@gmail.com
We hold all responses below in confidentiality.
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Email
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Your email
Name
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Address
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Telephone number (Cell or landline?)
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Your answer
Birthdate (optional)
Your answer
Female, Male, or other (optional)
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This experiential program may catalyze deep inner work. Tell us very briefly about your background in doing inner work.
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Health or Medical Issues or accessibility needs you want us to be aware of
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Are you currently taking any prescription, over-the-counter medications, or recreational drugs? If so, please list.
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Who to notify in case of illness or injury and their contact info (Phone, Text, etc.)
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Your answer
Any food restrictions? Use "Other" for multiple restrictions, and note what they are. We'll let you know if we can accommodate them.
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None
Vegetarian
Vegan
Dairy-free
Gluten-free
Other:
What fee do you intend to pay?
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$425
$595
$795
Other:
How are sending your $250 deposit?
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Deposit by snail mail (check payable to Anne Hayden, PO Box 181, Clinton, WA 98236)
Deposit by PayPal (send to:
nwsoulquest@gmail.com
) (Please add 3% PayPal fee)
Deposit via Zelle (use
nwsoulquest@gmail.com
as payee)
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