Name *

First Name

Last Name

Phone *

(###)

###

####

Commitment *

by checking this box, I agree to attend Sound Healing for all.

I will attend on Sunday April 20th 2-4PM

I will attend on Sunday October 19th 2-4PM

Image Release Agreement

By checking the box below I acknowledge that digital documentation may take place and give my permission for my image to be shared publicly on In Progress's social media sites.

I agree

There are circumstances I will speak to the host about prior to the activity