Starseed Summer Retreat 2022
Flathead Lake, Montana
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Do you prefer text or email?
Instagram handle:
*
Facebook handle (or any other social media platform we are connected on):
*
What food options do you prefer?
Vegetarian
Vegan
Meat, seafood + above
Any or no preference
Do you have any food allergies? If so please explain below:
*
What is your purchasing route for this retreat?
*
Payment plan ($222 due now)
Pay in full ($2222 due now)
If you are choosing a payment plan option, which route are you taking? (You can always modify this at anytime)
9 months ($222 monthly)
6 months ($333 monthly
3 months ($666 monthly)
A PayPal invoice will be sent to your email monthly, please write your preferred email address below:
*
Would you like to book a 30 min call with Jasmin-Lalani about this retreat?
*
Yes
No, that is ok! I am ready!
Choose your desired date & time (based on your time zone)
-
Month
-
Day
Year
Date
Do you agree to & sign a payment plan contract for the paid agreement plans? (Payment plan registrants only)
*
Yes
No
Paying in full
Do you agree to sign a liability waiver upon your arrival at the Starseed Summer Retreat 2022?
*
Yes
No
Do you agree to a non-refundable deposit due now to hold your spot and to complete this registration?
Yes
No
If you answered NO, then you are a disqualified applicant. Type YES if you agree!
*
Please state anything else you would like Jasmin-Lalani to know (any allergies or special requests here).
Signature
*
Send your deposit here:
prev
next
( X )
USD
Send you deposit here:
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: