Discover Your Medicine

Enrollment Form

$333 x 3 payments

Name*
First Last
Email*
Phone*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
What is your intention for joining this course?*
How do you currently show up in service to the world? How would you like to see this evolve?*
What experience do you with shamanic practice, or any other personal development work?*
Do you have any existing mental or physical health conditions that could impact or be impacted by your participation in this program?*
How did you hear about this program?*
Participation Fee (Payment 1 of 3)
Price:
Please note that your second and third payments will be auto-charged in 30-day cycles after your first payment.
Coupon
Credit Card
Card Details
Cardholder Name
Total
$0.00
Terms & Conditions*
- I have read and agree to the terms and conditions of this purchase.