DRUM HIRE &

WORKSHOP REGISTRATION

(For both Drum & Art Workshops)

Drum Hire(Required)

Drum hire is $20 for each drum you need to hire. Cash preferred or EFT: Salama Salem ing direct a/c bsb: 923100 acc: 62242711

Yes I need a drum.

No I’ll bring my own.

They are supplied by the venue.

n/a I’m doing an Art Workshop.

n/a I’m doing a Retreat (1 Day or 3 Day)

Name(Required)

First Last

Workshop Location(Required)

Click or tap on the box & select from the drop down menu the location of your workshop.

Workshop Type(Required)

Click or tap on the box & select from the drop down menu the type of workshop you are attending, there are a few different types.

Date of Workshop(Required)

Click or tap on the dropdown box to select the correct day, then month, then year.

Birthday(Required)

Click or tap on the dropdown box to select the correct day, then month, then year.

Phone(Required)

Email address(Required)

Address(Required)

Address City State Post Code Country

How did you find out about the workshop?(Required)

Click or tap on the box & select from the drop down menu.

Please list(Required)

Any notes?

e.g. If you are doing the Women’s Shamanic Drum Circle please note if you need to hire the 2 different types of drums.

Workshop Video + Join Newsletter

I would like to receive the workshop video tutorial recorded on the day & join the newsletter.

[Please note if you don’t opt-in but decide later you would like the tutorial video you will need to resubmit this form].

Media(Required)

Media

As part of our workshops Medicine Woman Drumming takes footage during the workshop to produce a tutorial video. I acknowledge that my photo & video could be taken during the workshop. By attending the workshop I am agreeing to the above.