2023 Retreat Host Request Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Select the preferred arrival date for your retreat.* This field is required.This just gives me a general idea of when you'd like to come; it can be changed later.

Date

4

Select the preferred departure date for your private retreat.* This field is required.This just gives me a general idea of when you'd like to leave; it can be changed later.

Date

5

Tell me a bit about your retreat and the work that you do.* This field is required.

If you're not sure, just give a few things that have attracted you to work with me

6

How many guests will be in attendance?* This field is required.The space is best configured for 8-10 attendees and 2 co-hosts.

7

Are your dates flexible?* This field is required.

Yes

No

8

What kind of vibe are you looking for?* This field is required.Check all that apply!

Erotic

Rest and relaxation

Grounding and centering

Shamanic spiritual healing

Plant Medicine

9

What additional activities are you interested in?* This field is required.Check all that apply!

Beach and Water

Yoga and Tai Chi

Meditation and Journaling

Hiking and Nature

10

What else would you like me to know? * This field is required.

What else would you like me to know about your traveler's budget and/or travel preferences?