Name *

First Name

Last Name

Phone *

Country

(###)

###

####

I agree to receive communication to this number via text message. Message and data rates may apply. *

Yes

No

Are you a member of the LFTD Social Club? *

Yes

No

I recently applied

Which do you prefer? Shared room with other men or other women going on the experience ($) OR a private hotel room ($$) *

Shared Room

Private Hotel Room

Can you make your first $150 deposit before May 1, 2024? *

Yes

No

Will you need a payment plan or will you be paying the experience in full (one payment)? *

Payment Plan (Three payments - $350 USD)

Full Payment (One-time payment - $1000 USD)