Immersion Registration Form

Ayurveda and Herbal Energetics for the Female Physiology

Registration Form
Name*

First NameMiddle NameLast Name
E-mail*
example@example.com
Mobile Number
Please provide your mailing address, so I can mail you your herbs for class*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website or Instagram handle:*
Level of study in Ayurveda:*
Occupation:
What is most important to you to get out of this immersion?*

Study of Ayurveda herbalism and energeticsStudy of Ayurveda herbal preparations and formulasUnderstanding Ayurveda and the menstrual cycleIncreasing effectiveness of my offeringsIncreasing my scope of practiceTasting new herbsSelf healingA space to ask questions of a mentorSeeing case studiesLearning from other practitionersMaking herbal preparations (ghees, tinctures, lickables, infusions)Other
If you chose 'other' what are you looking for in this class?
Would you like to share about how you express your sex and gender? Do you have any questions about if this course will give you tools to serve your community and clients?
This immersion is designed around understanding what may best serve female bodies, according to the understanding founded in Ayurveda energetics.
Do you have other questions regarding this program?
Who told you about this course? This helps me pay out my affiliates :)*
Thank you! Please confirm your registration for class by choosing your payment option below. All herbal products and shipping are included in the price of the program.

If you choose a payment plan/deposit option, you will recieve one more email to establish that automatic payment plan option through Square for the remaining balance.

If you have any questions in the mean time email me at adena@adenaroseayurveda.com

My Products

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Ayurveda Herbology Immersion (Deposit - Payment Plan)3 Monthly Payments of 250 thereafter (total $996). We will set this up through Square invoicing.

$249.00

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Ayurveda Herbology Immersion (Full Payment)Pay in Full Now

$895.00 Quantity

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Ayurveda and Herbal Energetics for the Female Physiology

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