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21 Day Breath Practice: Commitment Form

Step 1 of 3

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Congratulations on saying yes to a 21 day breath practice, where you receive a custom daily practice of Himalayan Kriya Kundalini Yoga practices to support your personal breath & voice goals.

By completing this form and remitting payment, you are agreeing to 21 consecutive days of doing this practice.

Name(Required)
Do you agree to 21 consecutive days of this custom breath practice?(Required)
I would like accountability support at my preferred contact method at this frequency.(Required)

Your Personal Practice Goals

This, in addition to our live conversation, helps me to craft a custom set of practices for your next 21 days.

I will primarily be doing this practice at the following time of day.(Required)
How do you desire to feel after each daily breath practice these next 21 days?(Required)

Logistics

Payment terms: Month 1 of 21-day custom practice with accountability via your primary preferred contact method = $4/day ($84 total). If a day is missed, Month 1 pricing applies to Month 2. If Month 1 is completed well, the following months with accountability become $3/day ($63).

This includes a 1 time 30-minute consult Zoom call and an unlisted Youtube instructional video for your personal custom practice. By enrolling, you agree to utilize your videos for personal use only.

I will notify Nicole at 808-638-1862 the day that I commence the 21 day daily commitment. If I miss a day of the 21 days, I agree to notify her and start from the beginning of the 21 days.(Required)
I agree to complete a Google form following the completion of this 21 day personal practice commitment.(Required)
I agree to be available for a 30 minute Zoom call during the last week of my 21 day practice.(Required)
I have paid Nicole @InspireGlobalHealing via Venmo.(Required)
Configuration Required: To use the Stripe field, please configure your Stripe Settings.
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