Name
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First Name
Last Name
What is your birthdate?
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MM
DD
YYYY
Phone
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(###)
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Email
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What is your social media handle?
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact Name
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First Name
Last Name
Emergency Contact Phone
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(###)
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Emergency Contact Email
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Which accommodations would you prefer?
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We will be contacting you to set up a zoom call to solidify your space. What is the best way to reach you?
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During EARTH you will be invited to unplug from work, social media, & phone in order to best uplift and support your full presence in this immersive space.
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We are choosing to hold EARTH as a plant medicine/substance free and fully present space. We ask each who participate to do the same.
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What does the landscape of your life currently look like?
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How would you describe your relationship with your body?
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We will be holding a group ceremony in which you will be guided to map your own internal pelvic floor. Do you have any questions about this portion?
This retreat will be an intimate container and feature bodywork. Are you comfortable receiving therapeutic touch from practitioners and other attendees?
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You are sovereign and may absolutely decide in the moment what feels right for you.
We will be encouraging all who feel comfortable being witnessed in full or partial nudity to join and follow along in certain ceremonial spaces as we honor and give love to our own bodies. Do you have any questions or concerns about this segment of our retreat?
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We will have a photographer on site during some of our events to capture our experience as a group, in addition to this, each woman will have the opportunity to receive two 1:1 mini photo sessions to embrace & celebrate her earthly essence. One will be in the desert, one will be underwater. These photos will become your personal property after the immersion & will only be shared by facilitators with reverence & with your express permission. We are excited to share this piece of our immersion with you, do you have any questions here?
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Do you have any dietary needs that we need to be aware of?
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Food will be prepared by a private Ayurvedic chef who has an emphasis on serving organic and local foods that will contain meat & could be adapted if desired. We strive to eat whole foods, both plant & animal. We will stay away from most anything processed. Everyone has vastly diverse dietary needs and we will do our best to accommodate, please tell us about yours.
If you are applying with a friend or relative, please include their name here & your relation:
Is there anything else that you'd like to share with us as we review your application?
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FINANCIAL AGREEMENT
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A deposit of $555 is required to reserve your space upon agreement.
Full financial commitment is required to be paid in full, a week prior to the set date of the immersion. There are no refunds for this immersion. The payments are transferrable.
Payment plans will be available
