Medicine Woman Rising Retreat Registration
Welcome to the Medicine Woman Rising Retreat! We are so thrilled that you will be a part of this circle and sacred space. Please complete the forms below upon registering for the retreat - it is important that we have this information no later than April 16th. Thank you so much! In good medicine & always with love, Caity
Email address *
Full Name *
Your answer
Phone Number *
Your answer
How did you hear about this retreat? *
Your answer
What is your intention for this retreat? What are you seeking to create and experience during this sacred time and space? *
Your answer
What does magic mean to you :) *
Your answer
Anything else you'd like me to know? *
Your answer
Dietary Restrictions - (please include any food allergies or sensitivities) - all meals will be vegetarian and you are welcome to bring your own snacks or additional food *
Your answer
Any other allergies or health restrictions we should know about? *
Your answer
What is your preference for housing? Please note all accommodations are shared and are priced according to their size (and don't worry about sharing space - we will have quiet hours from 10pm to 7am every day) *
Do you snore or have any other sleep issues or preferences? *
Your answer
Is there anyone on the retreat that you would like to be housed with? *
Your answer
Have you scheduled your one-on-one retreat check in call with Caity yet? *
Have you signed and filled out the release form yet? *
Have you sent in: *
Thank you SO much for filling this form out and for stepping in to this sacred circle. We are thrilled you will be with us for this weekend of learning & magic. Please do not hesitate to reach out to Caity with any questions or concerns. You can email me at or call (914) 806-7962.
You can schedule your one-on-one check in call with me here:

A copy of your responses will be emailed to the address you provided.
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