Registration form for animal guests

This form should be completed for each animal guest to be included in the Equinox event on 20 March 2018. All info that is shared is is treated with complete confidentiality.

Q1 - Q3 require an answer, but if you do not have the info, please write "unknown". Q4 - Q8 are optional - feel free to include as much or as little info as you like.

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

Please send us a head and shoulders pic of the animal, with the eyes showing, to earthhealadmin[at]gmail[dot]com

Thank you for registering the animal as a participant in the event. We will soon be in touch with you via e-mail.

* 1. Your name - Earth Heal member

* 2. Animal's personal details:

* 3. Animal's location during the event (nearest town/city, state, country):

* 4. The animal's three main personal focuses for this event:

* 5. Please list any health issues the animal needs help with, surgeries they have had and medications being taken:

* 6. Important periods and dates in the animal's life - include traumatic or stressful times and events, accidents, injuries, deaths, births, miscarriages or abortions, loss of family, moving home etc.:

* 7. Please list any specific problems/challenges the animal is having that the treatment should focus on:

* 8. If there is any other relevant info you would like to share with us, please do so in the box below: