Live Virtual Event Registration

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
3
E-mail* This field is required.
example@example.com
4
Is this your first live event with Coach Sharae?* This field is required.Select either yes or no.
Yes
No
5
Choose the date* This field is required.Select a date: 06/02/2023 7:00pm PDT or 07/07/2023 PDT 7:00pm
Date
Month
Day
Year
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Hour
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Minutes
PM
AM
PM
6
Leave a question or commentIf you have any specific question or comment just type it below.
(Make sure to type out all the things that you would need from our services, so that we can best serve all your business needs)
7
Please verify that you are human* This field is required.
Should be Empty: