Request edit access
Gem & Jam 2026 Topaz Healing Sanctuary Application
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
Phone Number *
Email Address *
Street Address, City, State, Zip *
What are your Qualifications/Certificates in? *
Are you certified in your modality? (This is required to touch people.) *
Required
Are you insured? (This is required if touching people) *
Required
Preferred healing modality for Gem & Jam: (Yoga teachers please use the Workshop form not this one) *
Would you like to teach a workshop in the Sanctuary if you are chosen to participate as a healer? If so, what would the workshop be about? *
Have you participated in a healing or wellness zone at a festival before?  *
Do you have an EZ Up, Bell Tent or other style of booth to work under? *
Required
Do you have Facebook or Instagram? If so, how many friends do you have between your personal and/or business pages that you can promote to? *
Are you willing to help promote Gem and Jam with posters and fliers in your city? This is not a requirement but is greatly appreciated :) If so, we will ship promo to you. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms