Emerge - Mother & Daughter Retreat 2022

The Emerge Retreat welcomes mom’s & daughters who are invested in enriching their lives by stepping out of the busy-ness of their everyday life. By gifting themselves the chance to focus on healing past wounds, to breathe through present-day chaos, and to make self-care a priority. The Emerge Retreat is a transformational, life-changing experience that will give you clarity, self-confidence, and communication skills.

Each day will offer opportunities to talk about getting out your comfort zone & resilience, finding your authentic self, positive self-talk, journaling, stress reduction, daily meditations, creating affirmations, self-understanding and self-esteem discussions, positive body image, negative media and technology effects (Instagram, etc), and more!

Note: daughters must be between the ages of 9 and 18 years old.

DATE:
Friday, September 29 @ 4:00 pm – Sunday, October 2 @ 4:00 pm

COST:
$975 + HST CAD for 2

Registration is due by September 15.

Service Fee Discount: save 10% discount if paid by etransfer (if paying by etransfer, you will receive the code to use prior to completing the phone)

Registration Information

Mother's Name *

First Name Last Name

Daughter's Name *

First Name Last Name

Mom Birth Date *

Month Day Year

Daughter Birth Date *

Month Day Year

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Home Number

Area Code Phone Number

Cell Number *

Area Code Phone Number

E-mail *

Emergency Information

Emergency Contact's Name *

First Name Last Name

Relationship *

Phone Number *

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Meal Preference: All food will be prepared and served at the Ma'ayan Chalet. These meals will include; Dinner Friday and Saturday; Breakfast & Lunch Saturday and Sunday, Snacks, Water, Coffee, Tea and Hot Chocolate are readily available throughout the day. *

Please let me know if you have any allergies.

Please provide all the necessary information.

Sleep Accommodations: There are beds in the cabin. I understand that I am required to bring my own blankets (sheets and pillows are provided). *

Yes, I agree

Are you a smoker? *

Yes, I will adhere to the rules set out for smoking No

I acknowledge and agree that my personal belongings are my responsibility. There are no secure places for them to be stored, with the exception of the vehicle I arrived in. I will not hold Bridging the Gap Wellness or Nature's Harmony Ecolodge responsible for my belongings. *

Yes, I agree

I have read and agree to the Cancellation & Refund Policy *

I agree. I understand that there are NO REFUNDS after you have registered. You CANNOT simply "transfer" your spot without approval from the owner of this event. The owner of this event will take into consideration, but this is not a given, the opportunity to move your registration as a credit to another event. If the owner cancels the event, a refund will be provided.

I have read and agree to the Cancellation & Refund Policy *

I agree. I understand that there are NO REFUNDS after you have registered. You CANNOT simply "transfer" your spot without approval from the owner of this event. The owner of this event will take into consideration, but this is not a given, the opportunity to move your registration as a credit to another event. If the owner cancels the event, a refund will be provided.

I understand that it is my responsibility to inform any facilitator or practitioner of any personal information, health or otherwise, that may be affected by any treatment received. I release Bridging the Gap Wellness, Nature's Harmony Ecolodge and it's team members and volunteers from all liability related to my treatment/service. *

I agree

Liability Agreement: 1. I certify that the above information is true and complete, to the best of my knowledge. I fully understand that I am solely responsible for my health, safety and well-being while participating in all retreat activities. I agree that I will inform my facilitators of any activity which I cannot perform safely, and that I will not perform any activity which I feel is likely to cause me to injure myself. I understand that there are risks associated with any physical exercise. While every precaution shall be taken to ensure the good welfare and protection of the participant, Bridging the Gap Wellness Team, Nature's Harmony Ecolodge, its staff members, employees, or volunteers are hereby released from any liability in the event of any accident or misfortune that may occur to the applicant. Each participant must be covered by Provincial Health Insurance or equivalent medical insurance. 2. In the event that a participant requires special medical, x-ray or treatment beyond that which is available at Nature's Harmony Ecolodge, the electronic acknowledgement on this registration shall give the Bridging the Gap Wellness/Nature's Harmony Ecolodge staff and/or volunteer the right to arrange for any special services and/or medical attention necessary for the participant’s welfare and good health. In such a situation, the Bridging the Gap Wellness/Nature's Harmony Ecolodge will attempt to notify the emergency contact as soon as possible. The participant is responsible for any additional expense that may result from such services including but not limited to the cost of emergency transportation to a medical centre or hospital if required. 3. I grant permission to Bridging the Gap Wellness/Nature's Harmony Ecolodge and persons acting for or through Bridging the Gap Wellness/Nature's Harmony Ecolodge the right to use, reproduce, and/or distribute photographs, films, video tapes and sound recordings of myself for use in materials they may create for purposes of promoting Bridging the Gap Wellness/Nature's Harmony Ecolodge. *

I have read and agree to the Liability Agreement

I understand that although I may choose to go swimming, who knows what Mother Nature has in store for us, there is no lifeguard on duty at any time and I swim at my own risk. *

I agree

Have you been to a Bridging the Gap Wellness Retreat before? *

Yes No

Have you been to Nature's Harmony Ecolodge before? *

Yes No

How/Where did you hear about this Retreat Weekend? *

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Save my spot *

Registration $ 975.00 CAD

If you choose to pay by etransfer, please reach out previously to make arrangements for payment and receive the required code.

Enter coupon

Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD

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