I am registering for:
ADDRESS:
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PHONE:
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CELL:
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EMAIL:
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DIETARY NEEDS OR HEALTH ISSUES:
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TOTAL INTENDED LENGTH OF STAY AT LA CUSINGA:
*** For people choosing to stay before or after the start or finish of the course.
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TOTAL INTENDED PAYMENT: ________________
(Sliding scale based on income level $1050-$1250 - includes beautiful dorm lodging, 3 farm-grown meals a day, and cost of course.
Please be mindful of paying what you can, this course is kept at a low cost to give those with a low income the opportunity to join us.)
PAYMENT SENT UPON REGISTRATION: ________________
PLEASE CHECK THOSE THAT APPLY:
* Make checks payable to The Gaia School of Healing.
* Send completed registration form and payments to:
The Gaia School of Healing, 172 Pine Banks Rd., Putney, VT 05346
Contact by phone or email: 617-838-8094, thegaiaschool@gmail.com
How did you find out about the Costa Rica Sacred Medicine Journey?
What are your specific interests regarding plants, healing, and spiritual practice?
What are you most looking forward to learning and experiencing during this course? What are your desires and expectations?
Do you have any questions about the course or your stay at La Cusinga that you would like answered?
Please take some time to tell Sage about yourself, and to ask her any questions that you have regarding this course. If you have any special needs or concerns, please voice them so that we can try to address them well before the start of the course.