Yoni Secrets

RedTent : Yoni Secrets

Pachamama House
21 Gordan Street, Hamilton,

or TempleZoom

Enrolment Intake Form

All information is held strictest confidence wtih Shantell Shakti, the organiser of this event. At no given point is information disclosed or shared with third parites, without your written consent.
Which date?*
How many are enrolling?

Dakini 1
Your Name*

First NameLast Name
Birth Date*

DayMonthYear
Phone Number*
Your Primary E-mail*

Dakini 2
Your Name*

First NameLast Name
Birth Date*

DayMonthYear
Phone Number
Your Primary E-mail*
example@example.com

Dakini 3
Your Name*

First NameLast Name
Birth Date*

DayMonthYear
Phone Number
Your Primary E-mail*
example@example.com

Dakini 4
Your Name*

First NameLast Name
Birth Date*

DayMonthYear
Phone Number
Your Primary E-mail*
example@example.com

end section
Contriution $280

Paypal option

Full Contribution$280.00AUD

Quantity

deposit$95.00AUD

Quantity

Enter coupon

Total $0.00AUD

EFT Option

$280 Full contribution, or

$95 Deposit

Love Magic Foundation
Bsb: 062 140
Acc: 1165 3430

Please remember to notify Shantell when you have made a payment to assist with accurate record keeping.
Applicant Declaration:

I have filled in this enrollment form honestly.

I have read, understand and agree to the refund and cancelation policy below.

I agree to pay the total amount indicated for this event.

This is my autograph and the date below.
date signed*
Autograph*

Clear
Sign by using a touch tablet/screen or left click and hold as you sign with your mouse.
Refund and Cancelation Policy
- More than 7 days notice of non-attendance:
  The payment made can be transferred to any other event, or private session facilitated by Shantell Shakti within 3-months.
  You may request a refund, minus $50 admin fee.
- Less than 7 days notice of non-attendance:
  No refund. Your Payment may be transferred to another event or private session with Shantell Shakti within a 3-month period.
- No notification given, or once the course has started:
  There are no refunds, or transfers.
- No refunds will be given for services received.
- If the event is cancelled, then a full refund, or full transfer applies.
Special circumstances will be considered for all the above.

If for any reason you are not completely satisfied with your experience, please email Shantell on shantellshakti@gmail.com and include your phone number so we can resolve any inconvenience or concern quickly and respectfully.
Should be Empty:

Enrolment Intake Form