HCF Retreat Registration Form (Healing Circle of Fire)

Welcome to Healing Circle of Fire Retreats!

NEXT RETREAT

WHEN: Nov 9-12 (Thurs 6pm - Sun 10am)

WHERE: Ashville, NC

FOCUS: Feminine Embodiment

ALL INCLUSIVE RATE: Shared Room = $1888; Private Room = $2222

FEMININE EMBODIMENT EDITION may be for you if:

-You long to feel more connected to your femininity, sensuality, sacred sexuality, and/or pleasure

-You long to feel more connected to, accepting of, and loving of your body and yourself

-You have blocks to sexuality, joy, pleasure, or self-love

-You feel you have been in your hyper-masculine energy and want to SLOW DOWN into presence and BEING

-You feel you have repressed your emotions and would like to get more in touch with them

-Your focus is always on taking care of others and you have forgotten to care for yourself

-You want to take your healing to the next level

ALL-INCLUSIVE RETREAT COST INCLUDES:

Lodging (3 nights) in beautiful mountain property ($800+ value)
Organic, healthy breakfast, lunch, dinner, and snacks. GF, DF, vegan options available ($600 value)
All retreat activities including: Inner child healing sessions, Meditation sessions, Breathwork sessions, Yoga classes, Art projects, Intuitive dance, Nature time, Red dress fire /cacao ceremony ($3000+ value)
Gift bags (e.g., crystals, journals, sage, red dress) ($300 value)
Conscious connection + healing within community (priceless)

First Name:*

Last Name:*

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age:*

Birthdate:*

Emergency Contact Person: *

Emergency Contact Phone: *

What is your line of work?*

How do you think this retreat might help you?*

Do you have any major medical or mental health problems that we need to be aware of? If so, please list. *

Please check any of the following symptoms that you may be experiencing.*

Have you ever meditated?*

YesNoMaybe

Have you ever done breathwork?

YesNoMaybe

Do you have a regular meditation and/or breathwork practice?*

YesNoMaybe

Have you ever done any inner child healing?*

YesNoMaybe

What types of things would you like to work on in this retreat?*

What types of healing practices or therapies have you already done?*

Are you willing to invest time, energy, and money into your own healing?

YesNoMaybe

Are you committed to showing up for yourself with courage and willingness, even when it's hard?*

YesNoMaybe

How committed are you to your own healing on a scale of 0 to 10? (0 = Not at all; 10 = I'm all in)*

Are you willing to sign a privacy and confidentiality statement to keep participants' personal information private?*

YesNo

Do you have any food allergies? If so, please list.*

Do you follow a specific diet? If so, please describe. *

Is there anything else you would like for us to know?*

If you would like to share a room with a specific roommate or roommates, please list their name(s) below.

We have a special gift for our participants. What is your dress size?*

How did you hear about Healing Circle of Fire Retreats?*

My Products

PRIVATE ROOM: Healing Circle of Fire Retreat: FEMININE EMBODIMENT EDITION (Nov 9-12)This is for a PRIVATE ROOM at the November Retreat.

$2,222.00 Quantity

SHARED ROOM: Healing Circle of Fire Retreat: FEMININE EMBODIMENT EDITION (Nov 9-12)This is for a SHARED room with 1-3 other guests.

$1,888.00 Quantity

DEPOSIT for SHARED ROOM: FEMININE EMBODIMENT RETREAT (TOTAL $1888)

$500.00 Quantity

DEPOSIT for PRIVATE ROOM: FEMININE EMBODIMENT RETREAT (TOTAL $2222)

$500.00 Quantity

Total

$0.00