6wk-bw-intake-payment-form| Grit and Gratitude

First name

Last name

Email

Phone

Location

How familiar are you with breathwork?

Beginner (Little to no experience)

Intermediate (Attended some sessions)

Experienced (Regular practice)

What’s your biggest challenge with stress or emotional management right now?

What do you hope to gain from this program?

I am fully committed to this program and my personal growth. I understand that this journey requires my full participation, presence, and dedication to achieve the best results.

Program Investment – Grit and Gratitude: 6-Week Intensive.