Participation Form

Dragon Heart Inner Journey Retreat Participant Application
Thank you for your interest in the Dragon Heart Inner Journey Retreat!

Dates: Friday, November 7, 2025 starting at 6 pm ET through Monday, November 10, 2025, at 11 am ET

Please complete this short application so we can ensure the retreat is a good fit for you and that we can accommodate your needs. Your answers will remain confidential.
Contact Information
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about the retreat?*
About You
What draws you to this retreat? What do you hope to gain?*
Do you have any experience with Human Design? Please describe below.*
The retreat may involve writing and sharing in small groups. How comfortable are you with these activities?*

Very comfortableSomewhat comfortableUnsureNot comfortable
Readiness & Safety
There are multiple outdoor activities planned that involve walking, moderate hiking and extended time on your feet. Do you have any questions, concerns or special requests regarding your ability to participate in these activities?*
Optional: Anything else you’d like us to know about you or your journey?
Payment, Accommodation and Transport Options
The cost of the retreat is $1,500, which includes shared bedroom accommodations, 8 meals, all activities and transport to activities. Shared accommodations include a Queen or Twin size bed, first-come first-served. After your application is accepted, you will receive a separate registration and liability form where you can list dietary needs and restrictions.

You may request a private room with either Queen or King size bed with an additional $200 fee that is subject to availability on a first-come first-served basis (see below).

There is a $500 nonrefundable deposit due to hold your spot. Payment plans are available for the balance due and is due in full by October 20, 2025.

Flights are not included. We may be able to coordinate airport transport or carpooling from Dulles Internaitonal Airport, Richmond International Airport or Charlottesville-Albemarle Airport upon request.
Please request your room and bed preference. Private rooms include an additional $200 fee.*

Shared room, Queen bedShared room, Twin bedShared room, no bed preference. Whatever is available.Private room, Queen bedPrivate room, King bedPrivate room, no bed size preference. Whatever is available.
What is your payment preference?*

Pay $500 deposit and the remainder by October 20, 2025Pay $1,500 or $1,700 (for private room) in full
Do you need airport transport assistance?*

YesNo
Next steps:

We’ll review your application and follow up with you within 1-2 business days. If we feel the retreat isn’t the right fit at this time, we may recommend other resources or invite you to future programs. Thank you for your interest. ~ Melanie Adrianna and Mary Jo Rathgeb
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Dragon Heart Inner Journey Retreat Participant Application

Contact Information

About You

Readiness & Safety

Payment, Accommodation and Transport Options

Next steps: