WORKSHOP FORM Name * First Name Last Name Email * Which workshop are you interested in registering for? Fire Cider + Food medicine Herbs/Plant medicine + Tea Alkhemy/Smoke Blends Self-Care/Stress Buster Strategies What is your main reason for coming to the workshop? Food Medicine Covid Prevention Empowerment Self-Care Relaxation and Stress relief Pain relief Spiritual Other What are your goals and expectations? * Do you have any health issues that affect your mind,body,spirit? * On a scale from 1 - 10, how stressful is your life/job/ currently? (10 being most stressful) * On a scale from 1 - 10, how physically active is your lifestyle? (10 being the most active) * Is there anything else you would like me to know? I take full responsibility for my health during the workshop. I am fully aware of this risk and hereby release Noble Alkhemy (Dee Davis) from any and all liability, negligence or other claims arising from or in any way connected with my participation in the workshop. Signed: Date: Thank you! I am looking forward to connecting with you on your yoga journey.
