Waiting List for Rebirthing The Sensual Self 2024
Fill out this form to get on the waiting list for Rebirthing the Sensual Self from 11-14 April 2024. The information you submit will be read by Mette and potentially the assistants. It will not be shared with anyone else. We don't always have capacity to respond to waiting list submissions until the moment when a spot becomes available. This usually happens very last-minute. It can happen on the day itself or on the 1-3 days beforehand. Don't hesitate to message Mette at +31641388030 (or @koppelaar on Telegram) if you want to know your chances. 

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Personal details
What's your first & last name? *
(and your pronouns?)
Your phone number? *
The number you use for Telegram (or Whatsapp).
Please include the country code: +49...
And your email? *
Only used for communication about this specific event
How did you find this weekend?
Optional question. Yet super helpful for me to know :)
If anyone is joining you as part of a couple/moresome, please write their name(s)
May I add you to the Telegram group for this retreat? *
The group is intended for practical information, for building some group energy beforehand, and enabling people to stay connected after the retreat. There will be an email sent out as well, but there will be no other communication channel for last-minute practical information, which means it would be great if you consent to this :)
About your journey
What's your intention for joining this particular retreat? *

What about the program, intention, or topic speaks to you? What's happening in your life that makes you want to join? What are you hoping to learn, practice, or experience? Are there specific things you want to let go of, transform, move on from? Are there things you want learn or try? 

You don't have to answer all these questions, and you don't have to write an essay, but please give me an idea of where you're at, so I can confidently let you into the retreat :) 

How do you feel about stepping into this kind of space? *

Do you have experience in sex-positive spaces? Are you a frequent visitor, an absolute newbie, or somewhere in between? Have you attended personal development retreats before? How do you feel about joining? Are you terrified? Easy-going? Excited?
There's no right or wrong answer here. It just helps me to know where you're at :)

Is your expression bound to relationship agreements?

 *

Meaning, are there certain things you've agreed not to do or things you've agreed not to do without checking in with your partner(s) first? You can select 'other' and explain a little about your agreements if that supports you. If you don't feel a need for that, then simply select 'yes' or 'no'. The reason we ask this question is that it helps us understand which dynamics are present in the space.

Where do you currently place yourself on the spectrums of gender and sexual orientation? *
Please don't feel obligated to share more than you're comfortable with. This info helps me have an understanding of the identities in the space. You're welcome to share other parts of your identity that feel important to mention. 
Are you capable of holding yourself in this experience? *
Some of the practices may touch you deeply. It may feel like that during the weekend and/or afterwards. If you’re not sure if you’re currently capable of holding yourself during/after such an experience, if you experience mental health problems, or if you have severe trauma that might show up during the workshops, please choose "other" and specify. I will reach out to you, so we can discuss your needs and decide together whether this is the right point in time for you to join. 
Do you have needs or sensitivities that we could be aware of to make the space more safe and inclusive to you?
This answer might relate to: physical accessibility, neurodiversity, inclusivity, and more. 

We'll make an effort to be supportive of your needs. We might not be able to look after everything that everyone answers here. We may reach out to you when we have questions about your answer. You may also reach out to us in case you have concerns. 
Values
If you join the workshops, I expect that you aspire to live up to the following values. Me and other team members also try to live by them ourselves. 
1. Do you wholeheartedly agree with the value of Authenticity?
 *
"We strive to create a container in which people can feel safe enough to express themselves in a wide range of ways. Feelings, desires and boundaries are at the core of this practice. We are free to experience and express them without justifying ourselves, yet we strive to do so in a way that’s considerate of other people."

Either click "yes" or click "other" and express your concerns. 
2. Do you wholeheartedly agree with the value of Inclusivity?
 *
"We strive to create an environment that’s inclusive to a wide range of identities. We don’t tolerate racist, sexist, ableist, homophobic, transphobic, ageist, or otherwise discriminatory behavior. We encourage everyone in the space to not make assumptions about people's identities and experiences (e.g. regarding gender, race, sexual orientation, etc)."

Either click "yes" or click "other" and express your concerns. 
3. Do you wholeheartedly agree with the value of Consent?
 *
"We respect each other's space, stuff, boundaries and privacy. We share a responsibility to create a safe environment for everyone. We communicate our own boundaries when needed and check the boundaries of people we interact with. We strive to create an environment in which we value giving and receiving our ‘yes’ as well as our ‘no’."

Either click "yes" or click "other" and express your concerns. 
4. Do you wholeheartedly agree with the value of Confidentiality?
 *
"We only talk about our own experience and don’t share about other people’s experiences. We don’t comment on other people’s experiences without their consent."

Either click "yes" or click "other" and express your concerns. 
5. Do you wholeheartedly agree with the value of Self and group responsibility?
 *
"We try to be aware of the ways in which we take up space and strive to contribute to the safety of the group. We’re all responsible for our own physical and emotional needs."

Either click "yes" or click "other" and express your concerns. 
6. Do you wholeheartedly agree with the value of No intimacy with facilitators?
 *
"Facilitators do not share arousal or sexual energy with participants. The only exception to this rule is when there's a pre-existing relationship, but even then it will not be pursued during the program. The facilitators are here to hold the space. Not to pursue their personal interests."

Either click "yes" or click "other" and express your concerns. 
Costs
Below I explain the default price structure. The budget for this particular event is quite tight, yet there may be one or two spots available for people who can't afford the default price. I know it can be hard to ask for such a spot when you need one yet I encourage you to do so if this is the case for you. My desire is for people in different financial circumstances to be able to join the course. Preference is given to people from marginalized groups or in challenging situations that make it hard for them to afford this weekend. 
Do you understand the following price structure? *

At the time of registration, I ask for €299 to cover costs like the venue, kitchen team, food, and assistants. If a spot becomes available and I offer it to you, I ask that you pay this amount immediately in order to confirm your spot. After the retreat has taken place, I ask you to donate for my facilitation.

I use this system to exclude as little as people as possible. The minimum donation is €1 (so I know that you didn’t forget it). You can base your donation on what the weekend brought you as well as your financial situation. Some people will donate more. Some will donate less. Don't worry if your budget is low. I take full responsibility for this system and I trust that the average donation will make things work out for me. I also believe that different financial means tend to reflect different backgrounds and that everybody benefits from having different backgrounds represented in the room. When you feel hesitant or ashamed of not being able to donate much, you're very welcome to message me at +31641388030 (or @koppelaar on Telegram) and I will gladly offer you some encouraging words.

If paying with Paypal
 *
Final question
Anything you'd like to add?
You can also message Mette at +31641388030 (or @koppelaar on Telegram)
Thanks so much for answering all these questions! <3
Now don't forget to submit the form :)
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