Participation Form

Participant Application
This application is applicable to both the Rewrite Your Story Workshop Series and the Dragon Heart Inner Journey Retreat.

Thank you for your interest in our workshop series and/or retreat! These experiences are designed for individuals who have moved through the most acute stages of loss or life transition and are ready to reflect, find meaning, and begin writing a new chapter of their lives.

Please complete this short application so we can ensure the workshop and/or retreat is a good fit for where you are in your journey. Your answers will remain confidential.
I am applying for:*

The Rewrite Your Story Workshop SeriesThe Dragon Heart Inner Journey RetreatBoth the Workshop and Retreat
Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
How did you hear about the workshop and retreat?
About You
Please briefly describe the life transition(s) or loss you’ve experienced that you’d like to reflect on during the event.*
When did this transition or loss occur?*
What support or healing work (if any) have you already done to process this experience? (e.g., therapy, support groups, journaling, coaching, personal practices)*
How would you describe where you are now in your healing journey? (check all that apply)*

I’m still in acute pain and actively grieving every day.I feel like I’ve begun to heal, but still feel stuck in the past.I’ve processed much of the pain and want to create meaning from what happened.I’m ready to let go of old patterns and write a new chapter.Other
What draws you to this workshop and/or retreat? What do you hope to gain?*
Are you currently working with a therapist, counselor or coach?*

YesNo
If you answered yes to the last question, please share briefly.
The workshop and retreat involve writing about your experiences and, if you choose, sharing in a small group. How comfortable are you with these activities?*

Very comfortableSomewhat comfortableUnsureNot comfortable
Readiness & Safety

This workshop is not a substitute for therapy and is designed for those who have processed enough of their grief or trauma to engage in reflective, creative work.
Do you feel you are emotionally ready for this kind of work?*

YesNot SureNo
Are there any specific triggers or concerns you’d like us to be aware of?*
Optional: Anything else you’d like us to know about you or your journey?
For Retreat Only: There are multiple outdoor activities planned that involve walking, moderate hiking and extended time on your feet. Do you have any questions or concerns about your ability to do these activities?
Next steps:

We’ll review your application and follow up with you within 1-2 business days. If we feel the workshop or retreat isn’t the right fit at this time, we may recommend other resources or invite you to future programs. Thank you for trusting us with your story.
Should be Empty:

Participant Application

Contact Information

About You

Readiness & Safety

Next steps: