Information to Enhance Your Individual Experience

*Carriage House at Genesis Spiritual Center*

Information to Enhance Your Individual Experience

Welcome aboard! I am excited that you are joining the SoulCollage® Facilitator Training. To make your stay at Genesis Spiritual Center as comfortable, safe, and enjoyable as possible, please complete this brief form. Your information will always be kept confidential.

What is the preferred spelling of your full name for your name tag:

Please provide the name and phone number of an Emergency Contact:

Please list any severe food allergies or dietary preferences.

Genesis can provide gluten-free, dairy-free and vegetarian options.

Please list any indoor environmental allergies.

For example, down feathers, perfumes

Please list any specific accessibility/ accommodation requests.

For example, no stairs, special bathroom access, etc.

Do you anticipate any specific challenges that you'd like me to be aware of?

For example, I need frequent movement breaks, I have a learning difference that makes scribing a challenge, etc.

Any other comments or concerns?

Name

First Name

Last Name