Ignite your Inner Life Registration and Payment Form

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Ignite your Inner Life 3-hour Workshop Registration Form

To register, please fill out this form and press the ’Submit’ button. You will then be prompted to review and sign a Disclaimer, Release and Indemnity form.
Name

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Primary E-mail
Primary Phone Number
USA phone numberFormat: (000) 000-0000.
City and State/Province
Are you 18 years of age or older?
Workshop Date

Select the workshop date that you wish to attend and register for today.
The workshop takes place on Saturday from 11:00 am to 2:00 pm MT.

Cost per Ignite your Inner Life Workshop$35.00

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Financial Assistance

If you need financial assistance contact Sheryl at Sheryl@heartofthematterretreat.org
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PLEASE READ: Before proceeding, you will be directed to a mandatory Disclaimer, Release, and Indemnity Form for joining the Ignite Your Inner Life Workshop. Upon clicking the submit button below, you will access this form.

Also, please take a moment to read our Terms and Conditions and Privacy Policy below.

Terms and Conditions

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Ignite your Inner Life 3-hour Workshop Registration Form