Return to Self: A Grounding Journey-Pilot Application

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Email* This field is required.Please provide your preferred email address. We'll use this for all correspondence regarding your application and the pilot program.
example@example.com
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Name* This field is required.What is your full name? We'll use this for your application and to address you during the program..
First Name
Last Name
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Phone NumberWhat is the best phone number to reach you, we will only use this to contact you if needed. In the unlikely event of an emergency, please provide a phone number where we can reach you.
Please enter a valid phone number.
4
What does 'return to self or 'being grounded' mean to you personally?
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What are you hoping to achieve, feel, or experience during your time in this six-week journey?* This field is required.
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What do you feel is your biggest challenge or block right now in relation to this journey?* This field is required.
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What is your greatest hope for this pilot program?* This field is required.
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Can you share what other modalities or practices you have previously tried to achieve these goals?
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The Grounding Journey is designed as a deep, immersive experience that requires a weekly time commitment of approximately 2 hours. Do you feel you can fully commit to this?* This field is required.
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Is there anything else you'd like to share about yourself or your journey that you feel is relevant to this application?
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How did you hear about The Grounding Journey pilot?
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Please Select
Social Media
From a Friend or Colleague
Website or Blog Post
A Community or Group
Other
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