Name *

Phone *

Email *

Address *

How did you hear about Whole Living Class? *

Facebook, Instagram, at the farm, the website, word of mouth, etc...

Do you have any severe allergies? *

Bees, food, etc.

Have you taken any herbal classes before?

How are you paying for class? *

In full (online or check)
Payment plan (online only)

All payment plans must be paid online. If you want to mail in a check, you may do so only if you are paying in full. *

Pay online in full or with a payment plan
Pay by check through mail (pay in full $2200, only)

Please send a check to 2317 Evergreen Rd, Louisa, VA, 23093. The check must be received within 10 days of submitting this registration form for $2200 for you to be considered registered for class.

I understand that class is held outside under a pavilion tent. *

I agree and understand that I must be paid in full by the first class. *

I agree and understand the Whole Living Class in non-refundable and non-transferable. *

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Whole Living Registration Form

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