Sacred Ceremonies Client Registration

Sacred Ceremonies

Client Registration
Thank you so much for entrusting me to facilitate your sacred ceremony. I am so looking forward to helping you celebrate and create the sacred space to embrace this transition with love and peace.

With gratitude, I ask that you please complete the following Client Registration at your earliest convenience to confirm your booking. Please set aside approximately 30 minutes to ensure that you can provide me with the most comprehensive and all-encompassing information, so that I might best serve you in creating a truely magical experience.

By initialling each section and electronically signing your name and the date upon completion, you are acknowledging that the information you have provided is true and correct. Roxanne May Birth Services respects your right to privacy and assures you that all answers are kept confidential unless otherwise required by law.
Please select which sacred ceremony you are seeking:*

Brigid [Maiden Blessing] Circle CeremonyDanu [Mother Blessing] Circle CeremonyCerridwen [Closing & Rebirth] Solo CeremonyCerridwen [Closing & Rebirth] Circle Ceremony
Contact Information

Circle Ceremony
Guest of Honour's Full Name*

First NameLast Name
Guest of Honour's Mobile Phone Number*

Area CodePhone Number
Guest of Honour's Email*
example@example.com
Proposed Date & Commencement Time of Ceremony*
Proposed Ceremony Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you hosting this sacred ceremony for yourself or a loved-one?*

MyselfLoved-one
Host's Full Name*

First NameLast Name
Host's Mobile Number*

Area CodePhone Number
Host's Email*
example@example.com
Do you have anyone to assist you with the planning and organising of the ceremony (especially on the day of the event)?*

NoYes
Co-host's Name
For me to liaise with on the day
Co-host's Mobile Number

Area CodePhone Number
Co-host's Email
example@example.com
Your Initials*

Clear
Contact Information

Solo Ceremony
Your Name*

First NameLast Name
Your Mobile Phone Number*

Area CodePhone Number
Your Email*
example@example.com
Ceremony location*

In-Clinic: The Womb Room GrangeIn-Clinic: The Nest Mooloolah ValleyIn-Home: Your Home Address
Please note that in-clinic ceremonies are available to book directly on my website according to the following schedule:
- The Womb Room Grange: Tuesday to Friday and on the last Sunday of each month
- The Nest Mooloolah Valley: Every Thursday
In home ceremonies are available on Sundays only by request. Please provide your proposed date below and I will confirm availablity via email.
Proposed Date & Time of Ceremony*
Proposed Ceremony Address*

Street Address

Street Address Line 2

CityState

Post Code
Your Initials

Clear
Ceremony Details

Guest of honour
Please select which circle ceremony package you have chosen:*

Basic Blessing Package [$444+GST]Deluxe Blessing Package [$666+GST]
Is the Brigid Blessing marking a special occasion/transition/rite of passage?*
eg. 30th birthday, bridal party event, preparation for conception journey, private womens circle
Date of birthday/wedding/special occasion if applicable

DayMonthYear
Date
Estimated Birth Date*

DayMonthYear
Date
What number baby/pregnancy is this for you?*
Including any rainbow babies
Please select which season your are honouring:*

Preconception - saying goodbye to the maiden to welcome the motherEarly birth, miscarriage, termination - honouring your spirit babyPostpartum - integrate and be held sharing your birth storyBreak-up/Divorce - to acknowledge to ending and clear energetic tiesHysterectomy/Menopause - to honour your Womb and welcome the next seasonOther life event - to explore all lessons learnt
Please select which phase you are currently in:*

Currently pregnantCurrently postpartum
Your estimated date of birth*

DayMonthYear
Date
Date you gave birth*

DayMonthYear
Date
What type of birth did you have*

Vaginal BirthInstrumental Assisted BirthCaesarean Birth
Please provide any additional information that you think would be beneficial to note
This information is integral to help me facilitate a deeply magical ceremony
Your Initials*

Clear
Ceremony Details

Solo Ceremony
Please select which season your are honouring:*

PreconceptionEarly birth, miscarriage, terminationPostpartumBreak-up/DivorceHysterectomy/MenopauseOther
Please select which phase you are currently in:*

Currently pregnant - preparing for postpartumCurrently postpartum
Your estimated date of birth:

DayMonthYear
Date
Date you gave birth:

DayMonthYear
Date
What type of birth did you have?

Vaginal BirthAssisted Vaginal BirthCaesarean Birth
Date that your breakup/divorce was finalised

DayMonthYear
If applicable
Date of your hysterectomy/last bleed

DayMonthYear
Date
Please provide any additional information that you think would be beneficial to note*
This information is integral to help me facilitate a deeply magical ceremony
Your Initials*

Clear
Ceremony Details

Circle Space & Atmosphere
How many guests do you propose will be in attendance at the sacred ceremony*
Please do not include the guest of honour in this count
How do you envision the sacred ceremony to feel?*

Fun/casualFormal/traditionalSpiritualEmpowering
How would you like to feel during and at the end of the sacred ceremony?*
eg. empowered, prepared, loved up
What emotions would you like to invoke in the guests during the sacred ceremony?*

Fun/PlayfulnessHappiness/JoyEmpowermentRelaxation/MeditativeDeep Diving/Soul SearchingOther
In terms of the guests attending, why have you invited this specific group? Are there any hesitations about this group of people attending an event like this?*
Are there any special considerations that Roxanne May should be aware of, including but not limited to history of trauma, religious and/or cultural factors etc?*
This information will help guide me to facilitate an emotionally and culturally safe event.
Where do you envision your sacred ceremony taking place?*

IndoorsOutdoors
The following questions are for sisters who have chosen the Deluxe Blessing package. Each blessing set-up will include the following:
- Boho canvas & woven floor rugs
- Throw cushions for each guest
- Rattan high-back floor chair for Guest-of-honour
- Drinking mugs for tea/cacao
I also have optional seating available for those who have trouble sitting on the floor. Please let me know if you would like to include:
- Low floor chairs (3x available)
- Dense-fill yoga boulsters (3x available)
Which ceremonial drink would you prefer:

Herbal Rose TeaCeremonial Cacao (made with soy milk)
For outdoor ceremonies, how do your envision the space?*

Set up amongst nature (eg. on your lawn)Cozy inside my boho bell tent ($55 rental fee for extra set up/pack down time)
The following questions will help me to create the perfect blessing altar, just for you. If you are happy for me to have creative freedom, you can skip this section.
Oracle/Tarot Cards

YesNoOther
Please Select From My Library of Card Decks
Crystal Grid

YesNoOther
If you have a favourite crystal/s please list them below
If you want
Which Goddess Statues do you feel drawn to?
Which preference do you have for candles?

White (Coco-Soy) CandlesYellow (Beeswax) Candles - subject to availability
Optional Extras

FlowersNo Flowers
Which flowers do you prefer?

Australian Natives $55Seasonal Blooms $55Host will supply (No charge)
Are there any additional elements for the altar or the blessing space that you would like to request?
I will aim to accomodate wherever possible
Your Initials*

Clear
Ceremony Outline

Circle Activity & Craft Options
The structure for each sacred ceremony follows a basic format of five stages:
- Stage 1: Beginning - the sacred space will be "opened" by inviting each attendee to call themself into the circle
- Stage 2: Shifting - each attendee introduces themself and sets their intention for sitting in circle
- Stage 3: Focusing - the guest-of-honour will be honoured, pampered and adorned with love, empowering energy and support through ritual activities and blessings for their upcoming rite of passage
- Stage 4: Completing - the circle will be completed with the chosen craft activities as a way to weave a web of connection for the guest-of-honour beyond the day of ceremony
- Stage 5: Feasting - the ceremony is concluded by sharing food together to help ground everyone's energy and shift from a sacred space back to a social space
Below are a list of various options for ritual activities, meditations, poems and crafts for you to choose from.
Stage 1: After opening the circle, would you like to include a meditation to help ground everyone into the space?*

No MeditationSinging Bowl MeditationMedicine Drum MeditationBody Scan MeditationVisualisation Guided MeditationOther
Optional Add-On: Would you like to add on a sacred Cacao or Rose tea ritual to open the heart chakra?*

No Cacao/Rose Tea RitualCacao Ritual $60.00Rose Tea Ritual $30.00Other
Stage 2: After introductions and intention setting, would you like to include a release ritual and gratitude sharing?*

No release ritual & gratitude sharingCasual release ritual & gratitude sharingFormal release ritual & gratitude sharingOther
For sisters who have chosen the "Cerridwen" Closing Ceremony:

Once everyone has settled into the space we will turn the focus to the guest-of-honour. A big part of a closing ceremony is acknowledging the guest-of-honours journey, as their loved ones hold space for them to share their story.

I encourage the guest-of-honour to physically write out the story that has prompted their transition of womanhood seasons, including:
- Preconception - saying goodbye to the maiden and welcome the next womanhood season;
- Early birth/miscarriage/termination - to honour the journey;
- Postpartum - to integrate and be held sharing your birth story;
- Break-up/Divorce - to acknowledge to end of a significant relationship and clear energetic ties;
- Hysterectomy/Menopause - to honour the womb and welcome the next womanhood season;
- Other life event eg. moving overseas/changing careers - to explore all the lessons learnt.
Please note: If the guest-of-honour is in their early postpartum, it's ideal to write out their birth story as early as possible after birth - starting their story at whatever point feels right. Their recollection of events with morph and change with time, so writing down the events as they remember them (at different points in their postpartum) can be helpful in creating a rich picture of how it looked, felt and transpired for them.
Stage 3: Please choose how you would like to gift/bless the guest-of-honour with love from the listed activities below (ritual activity 1 of 2)*

Bead Ritual: Each attendee brings a bead or beads to create a necklace/bracelet of loving support for the guest-to-beBath/Foot Soak Ritual: Each attendee brings foraged/collected herbs/flowers to be added to a bowl of healing salts that can be used in a bath or foot soakCandle Ritual (1): Each attendee brings a personal candle offering for the guest-of-honour to add to her sacred altarCrystal Ritual: Each attendee brings a crystal offering for the guest-of-honour to add to her sacred altarFlower Ritual: Each attendee brings a small bunch of flowers for the guest-of-honour to create a bouquet for her sacred altarLove Letters Ritual: Each attendee brings a love letter that they have written to the guest-of-honour to be read out in circleSacred Elements Ritual: Each attendee brings an item that represents a natural element (earth, air, fire, water) to add to the guest-of-honours sacred altar (eg. shells, flowers, feathers, oils, incense, candles, statues)Other
Stage 3: Please choose how you would like to pamper and adorn the guest-of-honour with love from the listed activities below (ritual activity 2 of 2)*

Candle Ritual (2): Each attendee will choose coloured embroidery floss to tie around a main candle while sharing words of affirmation and support for the guest-of-honourTea Blessings Ritual: Each attendee takes turns holding a cup of tea (which the guest-of-honour will drink) over their heart and instilling blessings for the guest-of-honour as she journeys through her rite of passageLaying of Hands Ritual: Each attendee places their hands (either physically or energetically) on the guest-of-honour to send her love and strength while stating words of affirmationMassage Ritual: Each attendee takes turns to massage the guest-of-honour (eg. feet, legs, hands, head) while giving loving words of supportHenna Ritual: Each attendee takes turns to create artwork on the guest-of-honours body celebrating their rite of passage (henna $10 extra charge)Rebozo Wrapping Ritual (Closing Ceremony Only): Attendees will come together to participate in a 'closing' ritual involving wrapping/cocooning the body with rebozo wraps, to support the guest-of-honour to come back home to her bodyOther
Stage 4: Please choose how you would like to weave a web of connection, from the listed craft activities below*

Affirmation CardsAir Dry Clay CreationsGoddess Eye'sGratitude JarMandala/Goddess ArtPainted Altar Candles *if candle ritual [1] was chosenSmudge (Herb) BundlesOther
Stage 5: After the feasting has concluded, would you like to include a red-thread/unity cord (maternal lineage) ritual to close the circle?*

No red-thread/unity cord ritualYes red-thread/unity cord ritualOther
Do you have any questions or are you unsure about any of the listen activities above?
Do you have any special meditations, poems or songs you would like to be incorporated into your sacred ceremony?
Are there any additional elements/rituals that you would like to be included in your sacred ceremony?
ie. the acknowledgement of an ancestor or a spirit child
Are there any elements/rituals that you would absolutely NOT like to be included in your sacred ceremony?
Your Initials *

Clear
Ceremony Outline

Solo Ceremony
The structure for a Cerridwen Closing & Rebirth ceremony follows the below basic structure:
- Stage 1: The sacred space will be "opened" with cacao or rose tea to connect with the heart and support you to share your intentions for the ceremony;
- Stage 2: You will have ample time to share your story and acknowledge the journey you have traversed, followed by a fire ritual to release any energy that is no longer serving you;
- Stage 3: You will begin our bodywork with either a Yoni steam, herb infused bath (in-home ceremony only), or foot soak ritual to encourage detoxification and adding warmth back to the womb space;
- Stage 4: You will receive a nourishing herb infused abdominal oil massage to move stagnant energy, increase energetic flow, and provide further warmth to your womb space;
- Stage 5: We will finish the sequence with a grounding 'Closing' ritual including full-body wrapping with rebozos, and a drum journey/guided meditation to support you to come back fully into your body;
- Stage 6: You will have time to journal your experience (if you feel called) and space to debrief anything that came up before we "Close" the ceremony with a cup of herbal tea and something sweet.
Would you prefer Cacao or Rose tea ritual to open the heart chakra?*

Cacao RitualRose Tea Ritual
A big element of a closing ceremony is having space held for your as you acknowledging your unique journey and share your story. I encourage you to physically write out the story that has prompted your transition of womanhood seasons, including:
- Preconception - saying goodbye to the maiden and welcome the next womanhood season;
- Early birth/miscarriage/termination - to honour the journey;
- Postpartum - to integrate and be held sharing your birth story;
- Break-up/Divorce - to acknowledge to end of a significant relationship and clear energetic ties;
- Hysterectomy/Menopause - to honour the womb and welcome the next womanhood season;
- Other life event eg. moving overseas/changing careers - to explore all the lessons learnt.
Please note: If you are in your early postpartum, it's ideal to write out your birth story as early as possible after birth - starting at whatever point feels right. Your recollection of events will morph and change with time, so writing down the events as you remember them (at different points in your postpartum) can be helpful in creating a rich picture of how it looked, felt and transpired.
For in-clinic ceremonies please select which "warming" practice you would prefer*

Yoni Steam RitualFoot Bath Ritual
For in-home ceremonies please select which "warming" practice you would prefer*

Yoni Steam RitualFoot Bath RitualHerbal Bath Ritual
Do you have any skin allergies or sensitivities?*

Yes (Please list in "other" option)NoOther
Do you have any food allergies or dietary requirements?*

Yes (Please list in "other" option)NoOther
Your Initials

Clear
Catering Details

Where applicable
Roxanne May offers 'platter style' catering at an additional cost of $25 per person with a minimum catering fee of $100. Please note that the fee listed on your final invoice will be based off the number of guests you have confirmed on this booking form. Roxanne May cannot provide discounts/refunds for last minute changes or cancellations of guests.
Do you require Roxanne May to cater for the sacred ceremony?*

NoYes
Please select which food/platter items you would like included*

Vegetable and dip platterSeasonal fruit platterBanana breadFinger sandwiches/wraps: Ham & Cheese, Egg & Lettuce, SaladMini quiches: Ham & cheese and/or Mushroom & SpinachOther
Do you or any guests have any special dietary requirements or food allergies*

NoYes
Please list below any applicable dietary requirements or food allergies
This information is integral to ensure no contamination occurs during preparation of the food.
Your Initials*

Clear
Important Information

Circle Agreements
In order to create a sacred ceremony facilitated with intention, there are certain aspects that must be followed to in order for all guests to feel safe. Please note that the following attendance agreement will be attached the the ceremony invitations.

All attendees must agree to:
- Consider the circle a sacred space and aim to honour this;
- Keep the guest-of-honour as the main focal point of the circle;
- Uphold confidentiality - whats said in the circle stays in the circle;
- Ensure that only one person speaks at a time so no-one gets spoken over;
- Keep their phone away from the circle (Only answering calls/texts in emergent circumstances, in which the guest will leave the circle to do so);
- Speak and listen from the heart;
- Be open to diverse points of view;
- Listen with discernment instead of judgment;
- Offer personal experience instead of advice;
- Welcome and hold space for all emotions to flow - witness rather than react (eg. avoid touching or distracting emotional releases from others);
- Above all else, be fully present throughout the circle - emotionally, physically and spiritually.
Please note that Roxanne May has an included travel radius of 20km from Grange, Queensland, 4051. For ceremony locations outside of this catchment, additional travel fees will apply – according to the location.
Where did you hear about my services?

Google SearchInstagramReferral from midwifeReferral from friendOther
By initialling at the end of each section and signing your name below, you confirm that you have read and understand all of the information listed, and are providing true and accurate information.
Clients Printed Name*

First NameLast Name
Clients Signature*

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Date*

DayMonthYear
Today's Date
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Sacred Ceremonies

Contact Information

Contact Information

Ceremony Details

Ceremony Details

Ceremony Details

Ceremony Outline

Ceremony Outline

Catering Details

Important Information