Wilding Women's Creative Retreat Interest form

1
Name
First Name
Last Name
2
Email
example@example.com
3
Phone Number
Area Code
Phone Number
4
Have you attended a Wilding Women's Retreat before?
Please Select
Please Select
Yes
No
Newbie
5
What is your Birthdate?
6
Where are you from?
7
Where do you currently live?
8
How did you hear about us?
Word of mouth
Instagram
Website
Google Search
The universe sent me to you
9
What’s your current occupation /what occupies most of your time?
10
How do you consider your level of confidence in the backcountry/high altitude?
Please Select
Please Select
Experienced-very confident
Moderate-confident
Variable-could use some help on how to prepare
Newbie-but ready to dive in
Newbie-have some fear, but with instructions I'm here for it
11
What is mainly drawing you towards this creative experience?
Please Select
Please Select
I want to try something new
Connection with myself, nature, and other women
I need to reset and find my creative drive
My therapist told me I need to get out of my comfort zone :)
I want to step into a deeper sense of self
12
What is your proudest achievement in life so far, why?
13
If you knew you could not fail, what would you risk doing or creating💭
14
Finally, is there anything else we should know about you? Tell us the coolest parts of yourself?
Should be Empty: