Celtic Tree Journey Booking Information

Email: ros@ros-simons.co.uk
Mobile: Ros Simons +44 (0) 7791 466619
Postal address: Ros Simons The Anchorage Ardpatrick Tarbert Argyll & Bute PA29 6YA

Please fill out this enquiry form so that we can begin a dialogue to co-create your unique spirit drum

Please make direct bank transfer payments to:
Rosalind Simons: sort code 60-83-71: account number: 30595637

Enquiry Form

Please:

type or write very clearly
inform Ros of any changes to the below information as soon as possible

First Name *

Last Name *

Preferred Name (if different from above)

Date of Birth *

Please enter your date of birth so I can work out your Birth Moon Tree

Email Address *

Enter your Email Address again

Street Address *

Address 2

City

County / State

Postal Code / Zip Code

Country

Home Tel

Mobile

Retreat Options

Choose your drum size *Option 1: 18" (hide & frame wood to be confirmed) deposit £200Option 2: 16" (hide & frame wood to be confirmed) deposit £160Option 3: 14" (hide & frame wood to be confirmed) deposit £150Options 4: 12" drum (hide & frame wood to be confirmed) deposit £125

Amount

Amount payable today

Make Payment via Online Banking

Consents and Declarations *I give consent to Ros Simons to hold and use my details given above for the purpose of my drum commissionI give consent to Ros Simons to hold and use my details given above for the purpose of informing me about other relevant courses and events. I note I can opt out of these communications at any time

Date

Additional Information

What draws you to ask me to birth a drum for you, please tell me a bit about yourself.

Please let me know a bit about how you will work with your drum? Will it be played for the majority of the time inside or outside? How will you be working with your drum - for healing, journeying, drum circles etc? Please give me as much information as possible!