Shimmering Heart Registration form

& Payment


Shimmering Hearts


Name *
Please let us know if you are either coming on Saturday, Sunday or Both
Please tell us if there is something we need to know about your health and if you are taking any medication.

All the information provided will be kept strictly confidential

Cacao Ceremony & Sweat Lodge
Parking Fee

Pay to account: R Ayala Silva, Sort Code: 07 02 46  Account Number: 47743721, Ref: Sweat Lodge