You are registering for:

More information about this event:

Current event status:

Your contact information

First name

Last name

Email

Type of email

PersonalWork

International calling code

Mobile phone (in case we have a question about your registration)

Would you like to receive our newsletter?

YesNo

I have read and agree to uphold the Healing Circles agreements

Show/Hide Payment Section

ShowHide

Support Healing Circles Global

Healing circles are offered at no charge. If you’re able, we invite you to make a gift to help cover the cost of your participation or join as a Community Supporter and donate so that others can participate.

$12 covers the cost of your participation in one circle
$24 covers your participation in one circle and pays it forward for another participant

Would you like to donate?

Yes

Donation amount:

Payment method

Credit Card

PayPal

Credit or Debit Card Information

Name on card

Cardholder address

Cardholder city

Cardholder state

Cardholder zipcode

Card Number

Expiration month (##)

Expiration year (##)

CVV (###)

If you have questions, please contact Petra Martin at petra.martin@healingcirclesglobal.org.

Tell us more

Paypal_Hidden_Fields

reCAPTCHA helps prevent automated form spam.

The submit button will be disabled until you complete the CAPTCHA.