FIRST & LAST NAME

EMAIL

PHONE #

FREE EMPOWERED GODDESS ROLLER BOTTLE for You & Your Friend When You Attend Together.
Enter Friends Name Here: (you will receive it at the event)

# OF EVENT PASSES REQUESTED? Attendees Must be 18 Years of Age or Older to Attend.
If purchasing more than one Event Pass, please Include their First & Last Name and Email so I can send them their event information and Gather their Birth Chart Info:

SELECTING MORE THAN ONE DATE INCREASES YOUR CHANCES OF PURCHASING A PASS IN THE EVENT YOUR FIRST CHOICE IS SOLD OUT

Please Indicate Your Choices Below:

MY FIRST CHOICE (check one box)

Saturday, August 14th
Wednesday, August 18th
Sunday, August 22nd - Full Moon

MY SECOND CHOICE (check one box)

Saturday, August 14th
Wednesday, August 18th
Sunday, August 22nd - Full Moon

MY THIRD CHOICE (check one box)

Saturday, August 14th
Wednesday, August 18th
Sunday, August 22nd - Full Moon

*IMPORTANT

I ACKNOWLEDGE THAT I ASSUME ALL RISK OF INJURY, DAMAGE, AND/OR LOSS AND THAT THE EVENT VENUE & ORGANIZERS WILL IN NO WAY BE HELD RESPONSIBLE. YOUR SAFETY AND WELLBEING IS IMPORTANT TO US.

THE VENUE IS IN THE COUNTRY WITH HILLS AND UNEVEN TERRAIN, BE SURE TO WEAR OR BRING APPROPRIATE FOOTWEAR TO BETTER ENSURE YOUR SAFETY AND COMFORT.

check this box to indicate you have read this safety statement and accept these terms.

THIS IS A RAIN OR SHINE EVENT. ADJUSTMENTS WILL BE MADE TO ACTIVITIES ACCORDINGLY.

PARKING
IS AT THE TOP TO YOUR RIGHT IN THE FIELD WHEN YOU ENTER OUR PROPERTY. SIX ADDITIONAL SPACES DOWN BY THE HOUSE, ARE RESERVED FOR THOSE WITH MOBILITY CHALLENGES.

EVENT ITINERARY
Will Be Sent to You With All Remaining Event Details & Info Once Payment has Been Received.

PLEASE LET ME KNOW HERE, IF YOU HAVE ANY QUESTIONS: