Somatic Embodiment Training (S.E.T.) Application Form

Name

First NameLast Name

Occupation

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail

example@example.com

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What most appeals to you about joining SET?

How do you see Breathwork + Somatic Coaching transforming your business and/or personal life?

What is your experience with therapeutic spaces and group work?

What is your ideal outcome after graduating our Somatic Embodiment Training?

What are you bringing/contributing to the container that we are co-creating together in the SET?

What is one challenge you may encounter in going through this training program?

In short - to the degree you have access to without causing dysregulation to your system - please describe your journey with trauma and early childhood development wounds.

What anchors of safety and stabilization have you found that support access to presence and regulation when experiencing activation in your system?

(In Person Retreat Only) We have contracted Turnip The Beetz to provide high quality plant based catering services for breakfast, lunch, and dinner, all included with your standard ticket. With this in mind, do you have any dietary restrictions that we should be aware of?

(In Person Retreat Only) Our standard ticket includes the options of a dormitory style sleeping arrangement (think camping indoors) or actual camping outside on the property, for our participants. We have secured sponsorship with Halfmoon yoga and will have limited materials to offer such as cushions and blankets. We strongly encourage you to bring your own sleeping mat/travel mattress, blankets, and pillows to ensure your comfort. Additionally, we have private rooms available for extra cost. If you are interested in upgrading to a private room, please choose the corresponding option below and we will reach out to you directly with our available rooms for your stay.

Do you identify as BIPOC and are in need of financial assistance? If so, we offer up to $300 off of your tuition in honouring the importance of equity and diversity. Please indicate if you would like to receive this benefit.

Are you in need of financial assistance? We offer payment plans and limited discounted options for those in sincere need. Please briefly share your circumstances here and we will reach out to you directly to discuss options further.

Which SET training date are you committed to join in 2025?

Do you have any questions before joining the SET?

If you are willing, please provide a high-resolution headshot to utilize for the Somatic Embodiment Training advertising.

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How did you hear about us?

Anything you want to add?

Payment+ Deposit Policy

To secure your spot in the training, please send $500 to: soulfulsomatic@gmail.com

The full payment of $3000 is due 15 days before the training dates. This may not apply if you have made previous arrangements with us or established an agreed-upon payment plan.

Should we not receive your payment within 15 days of the training, your attendance may be in question and your deposit may be applied to a future date.

If for whatever reason, you must cancel your attendance at our training, the Somatic Embodiment Training policy is as follows:

The deposit is non-refundable.

If cancelling 30+ days before the training begins, the full payment (minus deposit) is refundable.

If cancelling 15 - 30 days before the training begins, 50% payment (minus deposit) is non-refundable.

If cancelling 14 or fewer days before the training begins, 100% payment (minus deposit) is non-refundable.

If paying via PayPal, please note the 4% PayPal is non-refundable on any cancellations.

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Somatic Embodiment Training (S.E.T.) Application Form

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