Meet your Star Self - A Galactic Parallel Regression Experience 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.

All sales are final. The event will proceed rain or shine.

I agree to release event and property owners from any claim to both property and/or person by attending this event.

______________________________
Date & Signature

I would like to be informed of any future Aileen W. Donovan Events:
Yes No