Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Due Date (If pregnant)

MM

DD

YYYY

Start date of the event you are registering for *

MM

DD

YYYY

Cancellation Policy *

We have a 1 week cancellation policy before the start of each circle. If you cancel before 1 week of the start date you will receive a $200 refund ($50 will be maintained for an administrative fee). If you cancel your registration within one week of the start date you will not receive a refund. If you will not be able to come to a support circle you registered for, please let us know as soon as possible. There will be no reimbursement or makeup opportunities for sessions missed. By checking the box below you are acknowledging that you are aware of this policy. Thanks for understanding!

Waiver *

By checking this box you acknowledge that you agree to assume full responsibility for any risks, injuries or damages, known or unknown, which might incur as a result of participating in this event, workshop or service. You knowingly, voluntarily and expressly waive any claim you may have against Nurture (Bklyn) for injury or damages that you might sustain as a result of participating in this service.