Mt. Shasta 2021 Application
Hello! We are so glad you're here and excited for the opportunity to share in the magical energy of Mt. Shasta with you in our woman's spiritual retreat, from June 7 - 11, 2021. Please fill out this short application and we will contact you soon.

If you have any questions please contact Amy Sikarskie by email at or by phone at 972.835.4114
Email *
First Name *
Last Name *
Phone Number *
Email *
City, State & Country *
If you would like to be contacted by Skype or What's App please leave your contact info here.
How do you prefer to be contacted? Please check spam folder if you select the email option. *
If you have an instagram account, please share your username here.
This is a women’s retreat with activities focused towards the feminine energy. Are you female or identify as a female? *
Your Age *
How did you hear about our Mt. Shasta retreat? Select all that apply. *
If you were referred, please let us know who referred you?
Will you be joining with a friend?
Are you interested in carpooling?
Have you worked with Amy or Lea Anne in the past? *
What would you like to receive or experience in our time together? *
Which activities are you looking forward to? Check all that apply. *
What are some of your personal interests and hobbies? *
Mount Shasta is a sacred power center of divine feminine energy. Similar to Sedona, just being on the land and in the space begins a cleansing and activation process. Are you familiar with the energy of Mt. Shasta? *
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Will this be your first destination retreat? *
Our hearts are happy to share many of our gifts and services throughout the retreat. Which of the following have you experienced in the past? *
Our chef will prepare delicious vegetarian meals. Do you have any food allergies we should know about? *
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The investment is $2,500 and due in full prior to the retreat. We have a special available when paying in full. You can submit your first payment to reserve your spot now ( details on next page) or after a follow up call / email with Amy. What option works best for you? *
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