Speaker & Event Request Form
Thema Azize Serwa is always excited about opportunities to speak or service for your event. We love to bring The Womb Sauna to people who are ready to learn and experience what we provide.

Use this form to submit a request for The Womb Sauna to be present at your next upcoming event. To retain Thema for events there is a $300 retainer fee in addition to any necessary traveling, lodging, and food costs. If your request is for an online radio show speaking engagement or interview, the $300 retainer fee is waived with approval of the request. If you are a Certified Womb Sauna Practitioner, the $300 retainer fee is waived as well, but all traveling, lodging, and food costs must be paid.

For all other events, once your request is approved, to have it added to her calendar the $300 retainer fee must be paid first and you will receive an invoice for that fee. This retainer fee is non-refundable.
Sign in to Google to save your progress. Learn more
Tell Us Who You Are
Full Name *
Name of the Organization Submitting Request *
Email *
Phone *
What is your organization's website? *
Are you an approved Womb Sauna Practitioner in training or Certified Womb Sauna Practitioner? *
Tell Us About the Event
Please allow up to 3 business days for your request to be reviewed and responded to. In addition, the best way to ensure acceptance of your request is to have all the details when you complete this form. If you are not able to provide the information we are requesting below, your request will not be accepted.
Name of the Event *
Start Date and Time of Event *
End Date and Time of Event *
What type of event are you coordinating? *
Please describe what it is that you are requesting Thema to do at your event? *
Staff accommodations may be required.  What type of accommodations will you provide? *
Please summarize the event itinerary. *
If there are specific times that you'd like Thema to speak or provide a service please specify that timeframe.
What is the address for where the event is being held? *
If this event is outside of the Washington, DC Metropolitan area (within 20 miles) be prepared to pay for Thema's traveling, lodging, and food costs.
If this event requires overnight stay, please provide the proposed information for traveling, lodging, and eating arrangements. *
Once your request is approved, documentation of the aforementioned arrangements must be provided within 3 business days of approval.
If your request is approved, we absolutely will support all of your marketing efforts of the event to contribute to the success. *
Please check all boxes for how this event will be marketed.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy