Registration You must also add the event to your cart and purchase it in order for your registration to be accepted. Name * First Name Last Name Email * Phone (###) ### #### Event you are registering for * How did you hear about us? * Emergency Contact * Please include the name and phone number Liability Acknowledgement * By typing your name below you are: 1) Agreeing to release Wildflower Expressive Arts Therapies LLC, Wildflower Employees, and Art of Healing, Madison LLC from any and all liability in regards to the event you are registering for. 2) Showing you understand that you are consenting to participate in a workshop/event which contains activities that may be therapeutic in nature, and may elicit uncomfortable or vulnerable feelings. 3) Acknowledging that this workshop is not therapy and not intended to provide mental health diagnosis(es) or treatment. This space is intended for art making in a supportive environment and is not a place to process trauma or other mental health concerns. Date * MM DD YYYY Time Hour Minute Second AM PM Please notify us of any allergies, relevant medical conditions, or other accommodations that may be required, if any: Please include any questions or other important information about you below: Thank you! We will contact you once we have reviewed your registration.