Scorpio Moon Retreat Registration

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Pricing Starting at $678

PAYMENT PLANS AVAILABLE!

November 10-12 Women's Retreat in Harrison, ME

Includes accommodations, chef prepared meals and activities.

Email *

Full Name *

Phone Number *

Date of Birth *

YYYY

Occupation (If retired, previous occupation) *

Emergency Contact Name *

Emergency Contact Phone Number *

How did you hear about this retreat? *

Facebook

Instagram

Friend

Tiktok

Internet Search

Other:

Have you been to another Moon Retreat with Shelby & Alanna? *

Yes

Required

T-Shirt Size *

2XL

3XL

4XL

Select your room type... (You will be sent an invoice according to the room you have selected). *

Single Bed (Shared Room) $678 *These rooms have 2 twin beds, add a friend below, or you will be placed with a guest.

Full/Queen (Private Room) $777 *These rooms have 1 bed, add a friend below or the room will be kept private.

Would you like to add a friend to your single bed shared room for $555? You both will have a separate bed. (Please note the additional guest will need to fill out this form).

Yes (additional $555)

Maybe Later

Clear selection

Would you like to add a friend to your private full/queen room for $333? You will share a bed. (Please note the additional guest will need to fill out this form).

Yes (additional $333)

Maybe Later

Clear selection

Name of the person you would like to add to your room:

If you have been added to a private or shared room, what is the name of the person you will be staying with?

Do you have any allergies/sensitivities? (e.g. foods, environment, medications, perfumes, etc.) *

Yes

Please Specify...

All meals are provided on retreat and may include dairy, meat, and gluten. Do you have any special dietary restrictions or requirements? (e.g. vegan, lactose intolerance, gluten sensitivities) We will keep this in mind and have meals available for you. *

Yes

Please Specify...

Do you have any physical limitations or emotional/mental health concerns that may restrict you from practicing mindfulness or meditation safely? *

Yes

Please Specify...

Are you new to meditation? *

Yes

If no, how long have you been practicing?

What are you hoping to experience or learn during this retreat? *

Pease share any concerns about attending this retreat? If you have none, please leave blank.

Please feel free to share anything else you would like us to know about:

Would you like to receive information about future retreats? *

Yes

Please Sign to Acknowledge that ALL deposits are non-refundable.

How would you like to pay?

Payment plan (split invoice payments weekly until final payment on October 1)

50% due today with invoice, 50% due on October 1

100% due today with invoice

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