Welcome

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Please enter a valid phone number.

4

Instagram Handle

5

Preferred Contact Method

Instagram DM

Phone

Email

6

Where are you located?

7

Where would you like to experience your immersion day?Select One

Ojai, CA – Nestled in the mountains, near the river, with the option for a beach ceremony to close the day.

Texas – Choose from the rolling hill country, the mountains of West Texas, or a hidden pocket of nature in North Texas.

Virtual – Experience the full immersion from your own sacred space.

Other / Special Request – Let me know if there’s a place calling you.

8

What Drew You to Into the Flow?

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Where in Your Life Do You Feel Stuck, Heavy, or Disconnected?

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What Do You Desire to Move Toward?

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What Feels Most Alive for You Right Now?

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What Support Feels Most Nourishing to You?Select All That Apply

Deep intuitive coaching & reflection

Spiritual practice & ritual

Nature-based guidance & land connection

Energetic clearing & breathwork

Creative activation & self-expression

I’m not sure—I just know I need this

Somatic movement & body connection

13

Do You Have Any Experience With Somatic Work, Breathwork, or Energy Practices?

I have a deep practice with these modalities.

I’ve done some, but I’m still learning.

I’m completely new to this work.

14

This is a Deep, Intimate Experience—Are You Open to Being Gently Challenged to Expand?

Yes

No

I'm nervous but trust the process

15

Are You Interested in a Payment Plan?

Yes

No

Maybe, tell me more

Type option 4

16

Would You Like to Be Considered for the Scholarship Spot?

Yes

No

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Anything Else You’d Like Me to Know?

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Ready to Step In?

YES—I’m so ready to step into the flow!

I’m deeply interested, but I have a few questions first.

I’m still feeling it out—can I chat with you?