Empowered Women's Retreat in France!
We can't wait to see you in France! Please fill out the information below to join the retreat! When you send in your deposit of $250 then your space will be saved in the retreat. Remaining balance will be paid by March 15th. Thanks!
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Cell Phone *
Your answer
Mailing Address *
Your answer
City, State *
Your answer
Postal Code *
Your answer
Country *
Your answer
Date of Birth *
Your answer
Accommodations available *
Do you have a roommate or friend coming with you? *
If you have a roommate/friend coming along what is their name?
Your answer
Meals Preferred?
all meals are plant-based/vegan
What is your level of health? Do you have any physical injuries or limitations? *
Your answer
What is your level of fitness? Do you exercise regularly? Do yoga? *
Your answer
Emergency Contact *
with cell phone number
Your answer
How did you hear about the retreat? *
Please list website or person if applicable
Your answer
I have read and agree to the cancellation policy? *
Required
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