Individual Registration

Thank you for registering to 5 Elements Constellations 20th year Anniversary and Workshop Saturday November 14, 2026 9:30 AM. Please fill out the form and we look forward to seeing you.

An observing participant ($75) can participate in any constellation, but can not set-up a personal constellation (upgrades at the event will be possible).

$125 is the price for a personal constellation.

First Name *

Last Name *

Organization

Address *

Address 2

City *

State *

Zip *

Phone *

Email *

Choose: Observing Participant or Personal Constellation *

Observing Participant, $75

Personal Constellation, $125

How did you hear about this event? Check all that apply. *

Friend/Referral

Social media

Website

Newsletter

Other

If Other, where?

What are you hoping to gain from this event? *

Would you like to be added to our email list for future events and resources? *

Yes

Payment Information

Amount

Payment Processing Fee

Gross Amount

Payment Method *

Pay in person Credit Card

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

Credit or debit card*

REQUIRED - By signing up to this workshop/event and agreeing to the Privacy Policy and how we store and use your information. We do NOT store credit card information on this site.

John Cheney
Washington State Licensed Massage Practitioner
License number MA 60103537
NCBTMB Accredited
Resides in Seattle, WA. USA

(206)-526-8462
(206)-679-3961 mobile

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