Registration for ceremony 27 April 2024

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Please complete the relevant details below to register for the retreat. Once submitted and paid, you will receive further information, including what to bring, directions, etc.

Email *

Name and Surname *

Phone number *

Name and contact for next of kin *

The following questionnaire is intended to guide the facilitator and avoid risks to participants’ health. This information will be securely stored and will be kept confidential in accordance with current regulations.

We ask that you answer with absolute honesty and fill in all of the fields. The facilitator does not take responsibility for any problem arising from the omission of, or inaccuracy in the answers to the following questions.

This questionnaire is a mandatory part of your registration. We will not be able to confirm your participation until we have received it completed in ful.

For your own and everyone's safety, please disclose if you are suffering from, and/ or conditioned by any of the following -

Any current illness or health problem? If so, please provide details.

Low blood sugar and hypoglycemia

Diabetes

Tobacco sensitivity (tobacco is frequently used for prayer in ceremonies)

No serious medical or psychological conditions

Other:

Required

List any physical disabilities, conditions, past injuries or anything else that could affect your participation. *

What is your intention by attending this ceremony? *

Any additional comments or questions. *

Ceremony information

Ceremony 27 April 2024

The ceremony will be from 10:00 - 17:00 on Saturday, 27 April 2024.

The experience will be to develop self-care, self-knowledge and feminine expressions in your body and soul -

-consecration of cacao

-dynamic meditation

-song and dance

- painting and sewing

-integration sharing circle

-lunch included

Important points -

Please wear a skirt/ something feminine.

Please bring flowers, sacred objects, crystals, shakers, drums, etc

● I confirm that I have read and understand the information on this form.

● I confirm that I have answered all questions completely and honestly.

● I confirm that I have not withheld any information.

● I take full responsibility for the consequences of any missing information.

● I certify that I have been properly informed of the nature of the session and that I voluntarily participate.

I agree that I am solely responsible for myself, and I release and discharge Liesl Kruger, Paardebosch Farm and its representatives from, and against any and all, liability arising whatsoever from my participation in the retreat.

Payment information

Contribution: R650 per person

Payment can be made to the following account:

Name: Red Path South Africa

Bank: First National Bank

Account type: Cheque

Account number: 62608918340

Branch: Portside

Please use your name as reference.

A 50% non-refundable deposit, payable 14 days prior the event, secures your place.

Full payment is due 7 days prior to the event.

In the event of cancellation within 48 hours prior to the event, no refunds will be made.

Thank you, we look forward to sharing the sacred circle with you!

A copy of your responses will be emailed to the address you provided.

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