Full Name: *

Year of Birth: *

Phone Number: *

Email Address: *

City/Area of Residence: *

Health & Participation 

Do you have any medical conditions or allergies we should be aware of? *YesNo

If yes, please specify: *

Have you attended any art therapy or personal development workshops before? *YesNo

If yes, please share a bit about your experience: *

Creative Comfort 

How would you describe your comfort level with art-making? *Very ComfortableComfortableA Bit UnsureNew To This

What are you hoping to gain from this workshop? *

Occasionally, we may capture moments from our sessions—such as group activities or artwork displays—to help inspire others and reflect on our journey together. These may be shared in respectful ways, always with the spirit of protecting participants’ comfort and dignity.

I understand and agree on documenting my participation

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