Registration Form | ROSE ALCHEMY HEALING

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Rose Alchemy Healing

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Waiver

Please fill out the following form to attend an event or appointment with

Angela Jeanne Rose Heart - Rose Alchemy Healing.

First Name

Email Address

Last Name

Phone/Text

What event are you Registering for? *

Sedona Labyrinth Experience

Chakra Clearing, Drum Journey, Gong Bath

Elemental Connection Ceremony

1-on-1 Spiritual Awakening Support

Intuitive Oracle Card Reading

Reiki Session

Reiki & Sound Healing Session

Plant Medicine Journey

Reiki Training Certification

Inner Alchemy Activation

Private Session

Other

Choice 3

If there are other people joining you, please list their names.

Why are you drawn to this activity/ experience? What is your intention?

Do you have any medical or physical concerns?

Do you have any symptoms of being sick ie: cough, fever? COVID?

Do you have a question or concern to ask before the event/appointment?

Initials

I agree to the the refund policy and declare that the info I’ve provided is accurate & complete.

Thanks for submitting!

Contact Angela:

(808) 741-1559

AngelaJeanneRoseHeart@gmail.com

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CANCELLATION AND REFUND POLICY:

All deposits or payments received are non-refundable. There are no refunds or credits for partial attendance, sickness or poor weather. All sales are final. This is a firm policy.

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