Shimmering Heart Registration form

& Payment

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All the information provided will be kept strictly confidential

Name *
Name
Please indicate what your gender is, if any.
Please tell us if there is something we need to know about your health that may affect you in the cacao ceremony e.g heart problems, anxiety etc.
Cacao Ceremony

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