Application form

Have I piqued your attention? Are you dying to have a session with me? Then please fill out my application form and I will get back to you shortly.

Please fill it out to the best of your ability, otherwise you will have to redo it.

Miss Berry

Name

First Name

Last Name

Phone

(###)

###

####

Preferred dates

What would you like to explore?

Duration of Session

Hard limits

Do you have any additional needs? How can I accommodate your needs? ( this includes invisible disabilites )