Event Registration Form spray of purple flowers and greens

Event Registration Form

Event Registration Form

Date mm/dd/year*
Title of Event:*
Date of Event*
Name:*
Address:*
E-mail:*
Phone:*
-
What I would like to release*
What I would like to create*
Any other information I would like to share about my focus for participating in this Event*

RoseLight’s work in an Event involves our attaining meditative states of higher consciousness. The techniques we use include guided visualizations, energy awareness techniques, subtle energy bodies, and verbal releasing and sharing. Some of the self-examination, states of consciousness, and personal insights in this work can be very stimulating, exciting, or create emotional releases. If you have a mental, physical, or emotional condition that would make an Event unwise in the light of this knowledge, we advise you to reconsider participation.

I understand that I am free to ask any questions about or discuss these provisions at any time. I understand that Events are a form of life/stress management and pastoral care and are not a substitute for medical or psychotherapeutic care. I am at least 21 years of age, or, I provide with this booking form a written and signed letter from my parent or guardian giving RoseLight permission to work with me.

I understand that the Event tuition fee is nonrefundable once the Event has taken place.

Informed consent for Event*
Your initials to confirm consent*
Recaptcha Word Verification:
*