Body Temple: Foundations - Level 1 Application

Name *
Date of Birth *
Date of Birth
Phone *
Do you have an intention to complete all three of the Body Temple trainings? *
i.e. - Yoga Teacher Training, Reiki, Life Coaching
Some aspects of this immersion will include nudity. Are you willing to participate in the activities that involve nudity so long as it relates to the healing nature of the immersion? *
While nudity is 100% your choice and you will never be coherced or made to feel uncomfotablr because you choose to remain clothed, nudity in the temple space is encouraged as it may help you to release shame, grief, and allow you to achieve a level of sexual/sensual liberation that may not be experienced otherwise.
Your Priestess Power!
It's important for you to realize that while you are going to receive guidance and instruction during this training, you are also bringing your gift or presence, insight, and experience for all to be shared.
How do you see your role in the world? *
Are you still menstruating? *
This information is helpful for ceremonial preparation and teachings.
Sleeping Arrangements
There are four beds in the temple space. Participants who are first to register and have paid in Full will have the first option to choose a bed. Also note that the beds will be shared and there is a good chance you will be partnered with someone who you do not know. Based on this, please select your preference for sleeping arrangements. * Your preference will be considered but is not guaranteed unless you have paid in full.
Sleeping Arrangement Preference *
Allergies and Dietary Needs
Emergency Contact Information
Relationship between you and the Emergency Contact *
Relationship between you and the Emergency Contact
Emergency Contact Phone Number *
Emergency Contact Phone Number
American Disabilities Act
Do you have metal plates, epilepsy or are pregnant? *
Participant Acknowledgement and Cancellation Policy
Cancellation Policy *
A $150.00 non-refundable deposit is required at the time of submitting an application to attend the training. Please select "yes" to agree to the cancellation policy.
Type in First and Last Name to agree to the following Agreement of Release and Waiver of Liability
Date of Agreement *
Date of Agreement
This date indicates the date that you agreed to the above Agreement of Release and Waiver of Liability.
During the Body Temple training, the organizers will often take photos and/or videos of the participants engaging in workshops. Your photos could be used in future publications, multimedia presentations, and on the internet. You will also have access to the photos after the immersion. By signing below, you are giving The Way of the Wild Woman, The Wild Tribe, & Veronica Clark permission to use photos for the purposes stated above. *
Stay in touch with Veronica!
Thank you, Wild One! We can't wait to elevate with you!