Information for the Healing Sanctuary – Carol Everett Healing Sanctuary

WHO is included in your subscription, Yourself or Someone else, pet, situation etc? *

Allows 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 done that

Name (Primary Subscriber) *

First

Last

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

Email (Primary Subscriber) *

Email

Confirm Email

email 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, (Primary member or other)

Click or drag files to this area to upload. You can upload up to 2 files.