Family or group registration form

Please complete this form if you are signing up for the 21 December Solstice event, and will be including family, friends or pets in the event. All info that is shared is treated with complete confidentiality.

Q1 - Q6 require an answer, Q7 - Q8 are 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 form (without clicking the "Done" button) into the body of an e-mail and send it to earthhealadmin[at]gmail[dot]com

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

* 1. Name:

* 2. E-mail address:

* 3. Please let us know the number of adults, seniors, children and animals in your group (including yourself):

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

* 4. Please list the names of all the participants in your group (f known), including yourself, and their category e.g. adult:

* 5. Please indicate the method being used to pay for your group's participation in this event:

* 6. Date of payment:

* 7. Please tell us how you heard about this event:

* 8. 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:

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