Rooted Radiance Interest Survey

1
I have read the retreat description. Admission to this inaugural retreat is not guaranteed.
YESNO
2
Will you be attending this retreat alone?
YESNO
3
If you answered no, please list the participants that will be accompanying you? Please include the names and ages of all children. If attending with a coworker, please have them complete their own form.
4
Name
First Name
Last Name
5
Email
example@example.com
6
Phone Number
Please enter a valid phone number.
7
Profession
8
Preferred Pronouns
9
How did you hear about Rooted Radiance?
10
Have you ever attended a wellness retreat before?
YESNO
11
If yes, please share your experiences. Please share only what you feel comfortable disclosing.
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Ok
Ok
12
What is your current relationship with natural hair, wellness, and antiracist literacy practices?
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Ok
Ok
13
What specific topics or activities would you like to see covered during the retreat?
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Ok
Ok
14
What do you hope to gain or learn from attending Rooted Radiance?
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Ok
15
Do you have any suggestions for fostering a stronger sense of community during the retreat?
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Ok
Ok
16
Is there anything else you would like us to know or consider while planning Rooted Radiance?
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Ok
Ok
Should be Empty: