Retreat - October 2025

The Wild & Sacred Within Retreat

Pay in Full Early Bird Pricing Registration Page

$1,333

Filling out this form will take about 10-20 minutes to complete.

There is no "save" feature allowing you to start and come back later to finish.
Basic Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
How did you find out about this retreat?*
Please specify specific person or place you saw a flyer, etc. If you are returning or we know each other just put N/A

Logistics & Preferences
Do you have any dietary restrictions or allergies?*

YesNo
Please list with as much detail as possible for dietary restrictions or allergies*
Please list everything we would need to know to help you have a great experience at this retreat
Do you have any medical conditions, injuries, or mobility concerns we should be aware of?*

YesNo
Please list with as much detail as possible any medical conditions, injuries, or mobility concerns we should be aware of*
Have you been to a retreat before?*

YesNo
Please describe the kind of retreat you have been to.*
This retreat schedule is subject to change due to weather or other variables. While I will do my best to follow the original plan, do you understand and accept that some adjustments may be made?*

YesNo

Retreat Intentions & Experience
What drew you to this retreat?*
What are you hoping to release, gain, or experience?*
Do you have experience with Breathwork, energy work, or other healing practices?*
No experience needed—this just helps me guide you!
What’s something you want to deepen and/or release in your life?*
Ex: trust, clarity, connection, presence, grief, anxiety, stress.

Media Release (Optional)
There may be photos, video, and audio recordings taken at this retreat. Are you comfortable having your photo, video, or audio recorded and used for marketing purposes?

I understand I will receive no compensation for any use of these captured and recorded media files. I waive any right to inspect and/or approve any finished photograph, video, image, writing, or recording that may be used in connection with my likeness or testimonial or the manner of use of such media. I release and agree to hold harmless Host and its employees or agents, legal representatives or assigns and all persons acting under its permission from any liability relating to the publication of my likeness or testimonial, including and without limitation, claims for libel and/or invasion of any right to privacy.

Host may hire professional service providers (photo/video/streaming/audio) to document and display the Event. Host may also use social media (e.g. Instagram, Twitter) to: (i) post real-time photos and videos to its social media feeds; and (ii) display select submissions from those feeds on monitors throughout the event venue.

I understand that I am encouraged to capture my event experiences and post my own social content from the event (text, photos, audio, video), provided it does not infringe upon the rights of other attendees or Host. Such infringement would include, but is not limited to, defamation or infringement of intellectual property rights. In the event Attendee requires a release or permission to protect the rights of a third party, obtaining such a release or permission shall be the sole responsibility of Attendee.

I understand that some of the captured media (photo, video, or audio) may also be shared with and used by Nurture Through Nature for their marketing purposes.

I acknowledg and agree as follows: (a) Host may edit and use any Media captured at the Event for marketing and promotional activities and for any other lawful purpose in the ordinary course of its business; and (b) due to the prevalence of mobile recording devices in today’s world, Host disclaims all liability for the capture of Attendee’s likeness or image in any multimedia format by other attendees at the Event.
I agree and understand the Media Release*

YesNo
General Agreements & Policies
Please read each item below to understand what you are agreeing to:
1. I understand that this retreat involves physical and emotional activities, and I am responsible for my own well-being.
2. I acknowledge that this retreat is as much of a phone-free space as possible.
3. I agree to respect the privacy and experiences of others in the group.
I have read and 100% agree to the General Agreements & Policies*

Yes, I understand

Cancellation & Refund Policy
When you sign up, you are securing a space—both physically and energetically—that someone else may not be able to take.

No refunds will be issued unless due to an extreme emergency.

This includes:
- The sudden death of a family member
- A diagnosis of a life-altering illness
These circumstances or any circumstances like these do not qualify for a refund:
- Common Colds
- Mild illness
- Work conflicts
- Lack of planning in general
- Other personal emergencies
If one of these occurs you do have the option to transfer your ticket to someone else or forfeit your investment and spot at the retreat. If there is a waitlist, I will do my best to help you transfer your spot to another participant.

By signing up, you are committing to yourself and this experience. Thank you for honoring this space with your presence and intention.
I have read and agree to the Cancellation & Refund Policy*

Yes, I understand

Payment Terms & Agreements
By choosing a payment plan, you are committing to the full balance of the retreat, regardless of attendance. Payment plans are not a "pay-as-you-go" option—they are a structured way to break up the total cost.

All payments must be completed in full, even if you are unable to attend.
- No refunds will be issued, but you may transfer your spot to another participant or receive credit for a future retreat.
- In the case of an extreme emergency, please reach out, and we will work together to find a solution.
Extreme Emergencies Include:
- The sudden death of a family member
- A diagnosis of a life-altering illness
I have read and agree to the Payment Terms & Agreements*

Yes, I understand

Payment & Registration
Retreat Date: October 17-19, 2025

Location: Nurture Through Nature | Maine

All-Inclusive Pricing: Covers lodging, meals, Breathwork sessions, workshops, sauna, cacao ceremony, rituals, and a handmade ceramic mug.

Pay in Full

$1,333
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Payment for The Wild & Sacred Within Retreat*

Full Payment$1,333 paid in full today

$1,333.00

Total

$0.00

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The Wild & Sacred Within Retreat

Basic Information

Logistics & Preferences

Retreat Intentions & Experience

Health & Safety

Media Release (Optional)

General Agreements & Policies

Cancellation & Refund Policy

Payment Terms & Agreements

Payment & Registration

Credit Card