A Journey Through Senses

Participant Form

First Name

Last Name

Phone *

Email *

Date of birth *

Do you have any allergies or sensitivities to scents or other sensory elements? *

Allergies or Sensory Sensitivities

Do you consent to photos or videos taken during the workshop being used on our social media or website? *

Anything else you'd like us to know to help support your experience?

Pay Workshop

Fire & Flow Workshop

Date: June 11th

Time: 6-9 PM

Cost: $130 (no refunds)

Address:

Riverton, UT

(Exact address shared the week of)

$130

I Consent to Receive SMS Notifications, Alerts & Communications from Real Life Mentoring.