REGISTRATION FORM

Additional Rooms Now Available!
Kissimmee, Florida Sept. 11-15 2024 ~ 5-Days | 4-Nights Women's Retreat. Register Today.

Please complete ONE form per participant. SPOTS ARE LIMITED. For more details please email energyrejuven8@gmail.com. Looking forward to having you join this magnificent Women's healing retreat of a lifetime!
NOTE: If you plan to apply for a $500-$1200 SCHOLARSHIP, please do so BEFORE completing the retreat registration. You can apply by clicking the link here: https://form.jotform.com/231415329257051

You must wait for the response to your scholarship application BEFORE applying for the retreat. Scholarships are based on need and are first come, first served.
Sept 2024 Kissimmee Retreat
Name *

First NameLast Name
Your Hebrew name if different from what you wrote above. Include your middle name if you have one

First NameMiddle Name
Phone / WhatsApp *

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Current Age*
Marital Status *
What kind of work do you do? *
What is your background in Judaism?*
What are you looking to gain from this retreat?*
Any special dietary needs? We cannot guarantee we can meet them, but will certainly try :)*
Any special rooming requests? We cannot guarantee we can meet them, but will certainly try :)*
If you have already attended an Or Emuna Retreat in the past, is there something you wish to request or a thought you wish to share with us?*
Have you ever attended a retreat focused on emotional wellness before and if so with whom?*
Tell us a little about yourself and background/past experience with emotional healing or retreat?*
Share any thoughts you may have in joining this retreat including but not limited to your current emotional state, medications, physical limitations, specific challenges you are currently facing, concerns on what may arise during the retreat, etc*
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Sleeping Options for Kissimmee Florida Women's Retreat.

Read the following room descriptions and then choose your room option and complete payment before submitting your registration.

Choose from the following luxurious room accommodations. Note that all rooms have private toilet/shower and outside balcony or private lounge area.

King size bed -

Paradise Begonia King Bed Single Occupancy

$3500

Oasis Hibiscus King Bed Single Occupancy

$3400

Double Occupancy - this option is to sleep on a premium double size bed in a room with another guest in their own premium double size bed

$3400

Double Occupancy - this option is to sleep on a premium twin size bed in a room with another guest in their own premium twin size bed

$3300

Bunk Bed Option - this option is to sleep on a bunk bed with another guest, top is a twin bed, bottom a full size bed.

$3200

NOTE: If you plan to apply for a SCHOLARSHIP, please do so BEFORE completing the retreat registration. You can apply by clicking the link here: https://form.jotform.com/231415329257051

You must wait for the response to your scholarship application BEFORE applying for the retreat. Scholarships are based on need and are first come, first served.

Please select your room type from the options below. You'll be able to complete your payment on the next page (including a coupon code if you have one).*

Paradise Begonia Room$3,500.00

Single Occupancy Room with King Size Bed and En Suite Bathroom

Oasis Hibiscus$3,400.00

King Size Bed - single occupancy with a shared Bathroom

Double Occupancy Room with Double Beds$3,400.00

Double Occupancy Room With Twin Beds$3,300.00

Double Occupancy Bunkbed (twin over full)$3,200.00

Enter coupon

Total $0.00

By pressing 'yes' below you agree to the entire cancellation policy including (but not limited to) the COVID-19 policy, non-refundable payment, committment to pay the full retreat cost under all circumstances & conditions for this retreat and agree to them all (please refer to the bottom of the retreat page on the website for all the details on cancellation). You also have clearly read the above sleeping options and are clear to the bed accommodation you have chosen. If you are not clear about anything, please email us at energyrejuven8@gmail.com.*

yes
Proceed to Complete Payment

By pressing 'Submit my Registration' you agree to the following terms:
Your registration will NOT be valid unless you complete payment within 24 hrs for your retreat and room package you've selected here.

If you pay for a different room type on the payment page than what you selected here, your room is not guaranteed.

Payment Options:
To make it easier, we've added new payment options to make it easier to experience the beauty of this retreat. You can choose to split the payment into 3 or pay in full today and save hundreds of dollars automatically (no coupon required).

Scholarships:
If you've been approved for a scholarship, you can use the code that was provided specifically to you in the coupon code section of the payment page.

That's it! It's time to press 'Submit my Registration!' below and then add your payment details on the next page. We cannot wait to see you at the retreat!
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Additional Rooms Now Available!

Kissimmee, Florida Sept. 11-15 2024 ~ 5-Days | 4-Nights Women's Retreat. Register Today.

Proceed to Complete Payment