Event Registration Form

Event Registration Form

September 28th, 2024 - The Giving Place, Mt. Albert Ontario
Name*

First NameLast Name
Student E-mail*
example@example.com
Mobile Number
Astrology Intake Form
Full name at Birth

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Time of Birth

Hour Minutes

AM/PM Option
Place of Birth (City, Prov/State, Country)
Additional Comments
Payment method:

Credit Card - Payment page will be once you click submit.Cash or Etransfer - Paid to info@stephmahony.com - Disregard next page.
*IMPORTANT*

Thank you for registering to this event! You have the option to pay via eTransfer or Credit Card. If you have selected to pay by electronic transfer, you can send payment to Info@Stephmahony.com to secure your spot. No further action is required after clicking 'Submit'. If you would like to pay by credit card, please follow payment instructions on the next page.

Thank you for registering, we're looking forward to seeing you there!
Should be Empty:

Astrology Intake Form