Information for the Healing Sanctuary Please enable JavaScript in your browser to complete this form.WHO is included in your subscription, Yourself or Someone else, pet, situation etc? *Just Myself OR Plus AnotherAllows registering other people under your data. BUT You remain primary subscriber.Please confirm that you have met or exceeded the minimum sanctuary donation of £10 per month, otherwise' please return and amend your subscription *YES I have!Name (Primary Subscriber) *FirstLastDate of Birth, primary subscriber : dd/mm/yyyy *Email (Primary Subscriber) *EmailConfirm Emailemail of person responsible for maintaining membership Your main areas of concern for healing focus while included in The Healing Sanctuary, (Just a Short description) CLEARLY SEPARATE OTHER NAME if appilicable. *1st Main Subscriber name... Areas of concern. (NEW LINE) 2nd Secondary Subscriber name... Areas of concern Please upload a recent photo of yourself, (.jpg format) (Primary member or other) Click or drag files to this area to upload. You can upload up to 2 files. PhoneSubmit