Intention Setting

1
Please share your full Name* Dies ist ein Pflichtfeld.
First Name
Last Name
2
Please share your address* Dies ist ein Pflichtfeld.Please share your address for billing purposes
Street and number
Street and number (second line)
City
Country
Postal code
Bitte auswählen
Bitte auswählen
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Sonstige
Land
3
Please share Email-Adress* Dies ist ein Pflichtfeld.
4
And your WhatsApp Contact* Dies ist ein Pflichtfeld.
5
Please share your dietary preferences* Dies ist ein Pflichtfeld.Multiple answers possible
Vegetarian
Vegan
Gluten free
Other (please specify in the next field)
Allergies & intolerances (please specify in the next field)
6
If you selected 'other' in the previous field, please specify your dietary preferences here and list any allergies and intolerances
7
Please share your accommodation preference* Dies ist ein Pflichtfeld.
Shared room (3.250€)
Single Room (3.700€)
Other
8
Payment options* Dies ist ein Pflichtfeld.Please select your preferred payment option. You can choose between a one-time payment or monthly installments.
One-time payment (3.700€ Single Room / 3.250€ Shared Room)
3 monthly payments (à 1.267€ Single Room / à 1.117€ Shared Room)
6 monthly payments (à 634€ Single Room / à 559€ Shared Room)
Other installment preferences (please specify in the next field)
9
If you selected "Other" in the previous field, please specify your preferred installment plan. I’m always happy to find a solution that works for both of us to make this training accessible for you.
10
Do you have a history of epilepsy or have you ever experienced epileptic seizures?* Dies ist ein Pflichtfeld.
YesNo
11
Have you ever been or are currently under psychiatric are or are taking psychiatric medication?* Dies ist ein Pflichtfeld.
YesNo
12
Are you currently taking any other medications?* Dies ist ein Pflichtfeld.
YesNo
13
Are you currently pregnant or planning to become pregnant during the training period?* Dies ist ein Pflichtfeld.
YesNo
14
Commitment & Agreement* Dies ist ein Pflichtfeld.By submitting this registration, you confirm the following:
Should be Empty: