Retreat Application Form

Name *

First Name

Last Name

Best phone *

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What's your birth date? *

MM

DD

YYYY

What’s currently feeling out of alignment in your life? *

Select all that apply

I feel stressed & overwhelmed with daily life

I don’t take enough time for myself

I struggle to connect with my body & intuition

I feel disconnected from deep, like-minded friendships

I want more creativity & joy but don’t know how to access it