Fill out this form to apply for an upcoming retreat. Name * First Name Last Name Which retreat are you applying for? * WILD EMBODIMENT THE WORLD EYE AM ART Pro-nouns * Email * Email * please confirm your email Phone Number * Please include your country code When is your birthday? * MM DD YYYY Country of birth * Country of residence * Which element do you embody the most? * Earth (groundedness and balance) Water (fluidity and depth) Fire (passion and warmth) Air (expression and intellect) What word do you feel the most attracted to? * CONNECTION HEALING EMPOWERMENT EXPRESSION COMMUNITY What are you seeking from this experience? * Do you have any dietary restrictions? Sliding Scale * Supported Standard Supportive Energy Exchange Payment * In full Installments Questions or comments You will receive an email with payment options and follow-up information. See you soon 💜 Follow our journey.
