Information for the Healing Sanctuary – Carol Everett Healing Sanctuary

WHO is included in your subscription? DEPENDS ON any additional subscribers you previously REGISTERED. *

Select from drop down menu who is to be included under your subscription.

Please confirm that you have more than met the minimum sanctuary donation of £10 per person, otherwise' please return and amend your subscription *

YES I have included for added members

Name (Main Subscriber) *

First

Last

Date of Birth, Main subscriber : dd/mm/yyyy *

Email (Main Subscriber) *

Email

Confirm Email

Areas of healing focus for The Healing Sanctuary, (Short description, Main subscriber) *

Please upload a recent photo of yourself, (Main Subscriber)

Click or drag a file to this area to upload.

Name (additional mem 1) *

First

Last

Date of Birth, addn member 1 : dd/mm/yyyy *

Areas of healing focus for The Healing Sanctuary, (Short description, addn mem 1) *

Details of what you would like to work on in The Healing Sanctuary, mind, body and soul.

Additional member 1, recent photo

Click or drag a file to this area to upload.

Why is this person under your subscription1? *

They are a child
They are a pet
Other

Please specify reason1 *

Main reason for including this additional member in your subscription

Name (additional mem 2) *

First

Last

Date of Birth, addn mem 2 : dd/mm/yyyy *

Areas of healing focus for The Healing Sanctuary, (Short description, addn mem 2) *

Details of what you would like to work on in The Healing Sanctuary, mind, body and soul.

Additional member 2, recent photo

Click or drag a file to this area to upload.

Why is this person under your subscription2? *

They are a child
They are a pet
Other

Please specify reason2 *

Main reason for including this additional member in your subscription

Name (additional member 3) *

First

Last

Date of Birth addn mem 3 : dd/mm/yyyy *

Areas of healing focus for The Healing Sanctuary, (Short description, addn mem 3) *

Details of what you would like to work on in The Healing Sanctuary, mind, body and soul.

Additional member 3, recent photo

Click or drag a file to this area to upload.

Why is this person under your subscription3? *

They are a child
They are a pet
Other

Please specify reason3 *

Main reason for including this additional member in your subscription