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 Sweat Lodge e.g heart problems, anxiety etc.
Sweat Lodge Prices
Sweat Lodge Prices

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