CIRCLE  OF  INNER  LIGHT SPIRITUAL COMMUNITY

Retreats

Home

Mission Statement

About Circle of Inner Light

Our Services

Our Location

Spiritualism

Classes and
Scheduled Events

Ceremonies

Our Spiritualist Principles

Reverend
Virginia Collins

Mediumship
and
Intuitive Readings

Reverend
Debora Murray

No retreats currently scheduled.

FIELDS MARKED WITH * ARE REQUIRED

Payment Amt. sent:*     

Method Of Pay:   Check    Money Order   Pay Pay  

Date:            
Your Name:*      
Your Address:*   
City:*            State:* Zip Code:*
Phone:*           Cell:* 
e-mail:          


Emergency Contact: 1 Phone:
Emergency Contact: 2 Phone:

Special dietary/Food requests:

Do you have any medical/health-related challenges?  Yes     No
If yes, Please provide a brief description:   

Other pertinent information 



ACKNOWLEDGEMENT

I, by signing the below, acknowledge that I will not hold Circle Of Inner Light liable for any mishaps or illnesses which could occur during the scheduled retreat.

Signature of participant: Date:

Click on submit to send via email to:
LTeacherforLife@aol.com or www.circleofinnerlife.com
or print this form and send it by regular mail to:
Virginia Collins, 1607 Cook Avenue, Cleveland, Ohio 44109