Click here to download the Release Form
*Please print, sign and bring with you to the event*
Name: _____________________
Town: ______________________
Phone: _____________________
Email: _____________________
I do not have any medical/mental conditions nor do I take medication that may interfere with the hypnotic regression.
I am 18 years or older.
I am a minor (min. 14 years old) and accompanied by an adult.
______________________________
Date & Signature
Click here to download the Release Form.
It is mandatory to email me at [email protected] to attend.

