Please fill out our intake form in order to register for our upcoming workshop.

First name

Last name

Phone

Do you have any accessibility needs?

Do you have any allergies?

Acknowledgement / Waiver (Required Checkboxes)

I understand this is a creative , supportive arts workshop, not psychotherapy, counselling, or medical treatment.

I understand participation may involve emotional reflection and I am responsible for my own wellbeing.

I agree to respect group confidentiality.

I agree to release and hold harmless the facilitator, the venue, and any associated parties from any claims or liabilities arising from my participation, except in cases of gross negligence.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

I have read, understand, and agree to the waiver and consent above.

Product

CREATIVE ESCAPES WORKSHOP - Jan 21 - March 11, 2026$450

Product

Lavndr Pen Creative KIT$50

Registration is not complete until payment is not complete until payment is received.

@neutronstarr.life

Please fill out our intake form in order to register for our upcoming workshop.