Platinum Package

Name

First Last

Email

Phone

Which of the options are you interested in for the Platinum Package:

Coaching Sessions

Private Healing Sessions

Home Cleansing & Energy Balance

Energy Flow at work/business

Nutritional Guidance

Exercise Guidance

24/7 Access to Jerry Via Whatsapp

Healing For Horses Enquiry Form

"*" indicates required fields

First Name*

Last Name*

Email*

Phone*

How can we help you today?*

What is your main motivation for wanting to participate/ join?*

What are your goals for this workshop?*

This is a substantial investment in your future. How would you best describe your commitment level right now?*

I am committed to my journey and ready to invest in me

I still have a few questions to see if this is 100% for me

I am not ready to make a commitment but possibly in the future, so keep me updated on future events.

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Event Name

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Event Enquiry Form

"*" indicates required fields

First Name*

Last Name*

Email*

Phone*

How can we help you today?*

What is your main motivation for wanting to participate/ join?*

What are your goals for this workshop?*

This is a substantial investment in your future. How would you best describe your commitment level right now?*

I am committed to my journey and ready to invest in me

I still have a few questions to see if this is 100% for me

I am not ready to make a commitment but possibly in the future, so keep me updated on future events.

This field is hidden when viewing the form

Event Name

Name

This field is for validation purposes and should be left unchanged.

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Upcoming Experiences

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Winter Solstice Online Group Healing

Winter Solstice Online Group Healing

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Winter Solstice Online Group Healing

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