Retreat Registration 
RETREAT  COSTS:
Single Room $1,499
Shared Room $1,299
** all answers will be kept confidential**
Email *
First & Last Name 
 *
What is your email and phone number? *
Are you pregnant or nursing? *
Required
Do you have any physical concerns that might make the retreat difficult for you to participate in? *
Do you have a therapist or coach?
 *
Have you ever attended a retreat before? *
Why are you interested in attending this retreat?
What is your self-concept like now? How would you like to improve your relationship to yourself?  
 *
What are your hesitations about coming to this retreat? *
Do you have any past trauma that impacts you from functioning in your day-to-day life?
This is a coaching retreat, NOT THERAPY, You will go through experiences to help you become aware, accept and release emotion. During your weekend you might receive tools to support you with addressing trauma, but we are not offering therapeutic trauma healing. This includes domestic violence, abuse, stalking, coercion, current trauma, and/or other such behaviors and actions. Non of our team members are trained as clinically licensed trained therapists and you cannot rely on this retreat as an escape from these issues. It is appears that things are coming up for you that makes it unsafe for you to continue, you will be asked to not continue participation. *
Required
The fee is non-refundableIf for some reason you are not able to attend the retreat your fee will be applied to individual coaching zoom sessions. *
You will be responsible for your own transportation to the retreat, including transportation to the hotel from the airport.  
 *
Would you like to share a room or have your own?  (shared rooms are limited available based on even number of requests)
*
If you would like a shared room is there another participant that you would like to request to room with? (Requests are honored when available) 
Please list any dietary restrictions below *
What method of payment will you use? 
$200 deposit to save your spot
Payment plans available 
BALANCE DUE BEFORE 9/1/2024 *
I agree to have complete balance paid before 9/1/2024 *
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