sacred woman application | Soul Alchemy By Leilani

Sacred Woman Awakening Application

Deepen your journey into soul alchemy. Please share your essence with us as you step toward this sacred immersion.

First Name

Last Name

Email Address

Phone Number

Date of Birth

Month

Day

Year

Why do you feel called to this work?

Share the inner stirring that led you here.

What are your current challenges?

What are you currently navigating in your journey?

What are your intentions for this immersion?

What do you hope to awaken or transform?

Allergies or dietary restrictions

Please list any food, environmental, or medicinal allergies we should be aware of.

Physical or medical limitations

Please share any conditions or limitations that might affect your participation in physical activities or the immersion experience.

Anything else you would like to share?

Space for any additional reflections or questions.

Waiver and Terms

By signing below, you acknowledge that this immersion is a sacred journey of self-discovery. Please note that all bookings are non-refundable once confirmed.

I consent to this immersion and have shared all pertinent medical information. I understand that this is not medical or mental health treatment. I acknowledge that Soul Alchemy, LLC and Leilani Stafford are not responsible for any injuries or harm that may occur during this immersion.

I have read and agree to the waiver and understand the non-refundable booking policy.

Signature

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Date

Month

Day

Year