Request edit access
Ghana Submission Form
Dear Potential Guest,

Thank you for your interest in joining us for in Ghana.

This form is NOT an application versus an opportunity to make sure this specific retreat is best suited for you or perhaps a future one. We want your time and money to be WELL spent!

Please be as transparent with your answers as possible. All information supplied here is confidential.

We will be in touch within 1 business day of receiving your answers.

NOTE: this retreat is open to women and men.

Thank you for taking the time to fill the form out!

Love + Light,

Christina
Email address *
First + Last Name *
Your answer
Kindly provide us your social media (IG, Facebook, Twitter) or LinkedIn *
Your answer
City + State of Residence *
Your answer
FULL D.O.B. MM/DD/YY *
Your answer
Occupation (if self-employed provide a short description of your work) *
Your answer
How did you hear about the retreat? Pls provide the individual's name, social page or media outlet. Ex. Christina Rice Instagram, OMNoire page, Amanda Seales Podcast, Essence, Google, etc. *
Your answer
Upon notification, will you be ready to book immediately whether full payment or payment plan? *
What are you hoping to get out of this retreat? *
Your answer
Have you attended a wellness retreat before? *
If yes, what was your experience?
Your answer
How would you describe your personality? *
Are you traveling solo, with a significant other or friend? *
If traveling solo, have you traveled by yourself before?
If traveling solo, are you booking a solo room or would like to be paired with another guest?
What type of traveler are you? *
Are you comfortable engaging, networking, conversing with people you do not know? *
If no or sometimes, please explain.
Your answer
Are you comfortable in social events with a large group of people?
Do you have any fears? If yes, please explain *
Your answer
Do you have any emotional triggers/traumas we should be aware of? Please be completely honest. Your answer allows us to be more in tune with your needs while on the trip. *
Your answer
Feel free to tell us more about yourself if you wish.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy