A Year to Live: Registration Form
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
*
example@example.com
What is calling you to this journey at this time?
*
Is there anything you’d like me to know about your current life circumstances, health, or emotional well-being that may be helpful in supporting you during this year?
*
Select which group you would like to join beginning January 2026:
*
Group A: 1st Monday of each month
Group B: 1st Wednesday of each month
Either group could work
Submit
Should be Empty: