Better Gray Retreat Interest Questionnaire

Better Gray Retreat Interest Questionnaire

Reflection & Renewal Wellness Retreat (Nov 7–8, 2026). This questionnaire is for adults 40+ who are genuinely interested in attending the Better Gray Reflection & Renewal Wellness Retreat (Nov 7–8, 2026). Your input will help us design an intentional and restorative experience. Please note: this retreat can only move forward with confirmed participant commitment, including the financial commitment and required deposit to secure your spot. All contact information is confidential and used exclusively for planning purposes.
What are your Top Wellness Priorities (select all that apply)
If you selected 'Other' for your wellness priorities, please specify:
Retreat Activities of Interest (select all that apply)
Dietary Preferences
If you selected 'Other' for dietary preferences, please specify:
Do you have any food allergies or sensitivities?
If yes, please list your food allergies or sensitivities:
Mobility Level
(Mobility & Accessibility Notice Please note: While we strive to create a welcoming and supportive experience for all guests, the retreat provider cannot guarantee that all retreat spaces, pathways, and activities will be fully accessible for individuals with mobility limitations or disabilities. We encourage participants with specific accessibility needs to contact us in advance so we can discuss available accommodations whenever possible.)
Accessibility Needs or Medical Considerations (please describe any accommodations or considerations for your comfort/safety)
Sleeping Arrangement Preference (Select one)
All-Inclusive Price Selection-Please choose your preferred 2-day retreat package. The prices listed below represent the per-person cost for the full 2-day experience, including events listed in the retreat activity section, lodging, and meals.
Are you comfortable making an $800.00 deposit by Monday, March 2, 2026 to lock in this room rate?
Payment Preference
Refund Policy AcknowledgmentPlease note that the retreat provider does not offer cancellations or refunds. If you are unable to attend, you may receive a credit toward a future stay or service, or you may choose to reschedule your visit for another available date.
What would make this the perfect retreat for you?
Interest in Attending (select all that apply)
If you selected 'Other' for your interest in attending, please specify:
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty: