Winter Soul Renewal Journey Registration Form
To register, please complete the following three steps:  a) complete the form below, b) download and complete our release form from the journey page on our website, and c) send a deposit of $300 to Lead Feather, 23 Vista del Cerro, Santa Fe NM 87508.  Thanks and look forward to seeing you on the journey!
Sign in to Google to save your progress. Learn more
Your Name
Street Address
City
State
Zip code
Cell phone
Email address
Date of birth, including year (we need this to give the Forest Service)
Emergency contact and his/her relationship to you
Phone number for emergency contact
Please list any dietary restrictions or preferences that you have
Are you a coffee or tea drinker?  If so, please share details here (caffeine vs. herbal, morning only, etc.)
Please list any allergies that you have and what medications you take for them
Please list any other medical issues and/or medications you take
How would you describe your level of physical fitness?  What type of exercise do you currently do?
Are there any anxieties or worries about the journey that you'd like us to know about?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lead Feather Inc.. Report Abuse
Google Forms