Registration form - multiple guests

Please complete this form if you will be including more than one human or animal guests in the Solstice event on 21 December 2017. All info that is shared is treated with complete confidentiality.

Q1 - Q5 require an answer, Q6 is optional.

Send the form by clicking the 'Done' button at the bottom of the page when you have finished, or if you prefer to send it via e-mail, just copy and paste the completed form (without clicking the "Done" button) into the body of an e-mail and send it to Edna's personal mail or to earthhealadmin[at]gmail[dot]com

Thank you for registering your guests in the event. We will be in touch with you soon via e-mail.

* 1. Your name - Earth Heal member:

* 2. Please let us know the number of guests you will be including: adults, seniors, children and animals

  One Two Three Four Five
Seniors (over 65)
Children (under 18)

* 3. Please list the names of each of your guests (if known), including yourself, and their category e.g. adult:

* 4. Please indicate the method being used to pay for your guests' participation in the event:

* 5. Date of payment:

* 6. If there is any other relevant info you would like to share with us about the group or family being included in the event, please do so in the  box below: