RADIATE LIGHT GUILD APPLICATION FOR:

Annual Payment Plan of $177/yr.

Radiate Light Guild Membership Application

First Name

Last name

Title/Credentials (MD, CHt, ect.)

Business Name (if applicable)

Phone

City & State

Website/Social Links

Describe your work or intention

How long have you been on this path?

What draws you to the Guild at this time?

What do you hope to receive?

What do you feel called to offer?

Services You Offer

Liability Insurance?

Yes

In Process

Experience In Shared Spaces

Openness To Collaboration

How You Care For Your Nervous System

By enrolling, you agree to:

• A 12-month energetic and financial commitment

• Recurring yearly withdrawals until subscription is cancelled

• All fees are non-refundable & non-transferable

• Missed payments must be resolved within 5 business days

• Visibility & promotions are offered as opportunities—not guarantees

• Membership may be revoked for ethical or community violations

By submitting this form, you consent to these terms and acknowledge your digital signature.