Retreat Registration Form

Name *

First Name

Last Name

Phone *

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Check the add on services you are interested in.

Please check the box of any additional services you are interested in. We would like this info for scheduling purposes.

Massage

Reiki

Divination Reading

Classes

Please select your preferred method of payment: *

Kindly be aware that a 3% processing fee applies to credit card payments. We appreciate your understanding. We will send you an invoice within 48 business hours of form submission. Your spot will not be secured until payment is received.

Credit Card

Venmo

Paypal

Zelle

Payment Method Selection: Full or Partial Payment *

I understand that if I am making a partial payment under the early bird special, the full payment must be completed by June 1, 2025. Otherwise, the full price of the retreat will apply. Payment in full is required July 2, 2025. If payment is not received you will forfeit your spot and deposit. See below for acknowledgement.

Payment in full

Partial Payment

Retreat Reservation and Payment Acknowledgment *

By checking this box, I acknowledge that my spot for the retreat will not be secured until payment has been received. I also understand that payment in full is required 30 days prior to the retreat. If payment is not received by this deadline, I forfeit both my spot and deposit. Additionally, I understand that if I cancel my reservation after July 2, 2025, my deposit will be forfeited.

By checking this box I acknowledge the above statement

Retreat Guidelines *

Please be advised that no children or pets are allowed at the retreat. Thank you for your understanding!

I acknowledge that no children or pets are allowed at the retreat

Media Consent *

We may capture video or photographs during this retreat. Please let us know if you consent to being photographed or filmed.

Yes, I am okay with being on video and/or photographed during this retreat

No, I do not want to be on video or photographed