Application for "The Daughter's Release: Remembering the Woman You Are"
Please answer the following questions honestly and completely. Since this is an intense, intimate retreat (6 attendees), we want to ensure this container is the right fit for your current stage of healing.
Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Are you available for the entire duration of the retreat? (Friday 2 PM – Saturday 11 AM, September 24–26, 2026)
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Yes
No
Section 2: Choosing Your Sanctuary Please select your preferred Accommodation Tier:
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Tier 4: The King's Corner (Private) $1,500
Tier 3: The King's Corner (Shared) $1,111
Tier 2: The Cozy Twin/Day bed (Shared Room) $999.00
Tier 1: The loft; Pull Out Sofa (Shared Room) $888.00
Are you interested in purchasing the exclusive 1:1 coaching add on? The deepest work happens when you return home. To ensure you successfully integrate the profound ancestral and emotional shifts from the retreat into your daily life, we offer an exclusive Integration Coaching Package. This package is only available to retreat attendees, providing personalized support while the energy of the breakthrough is still potent.
Yes
No
Maybe, Send me information
Note: Spots are first-come, first-served. If your preferred tier is full, are you open to an alternative? [Yes / No]
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Please Select
Yes
No
Dietary Needs: Do you have any allergies (e.g., gluten, dairy, nuts) or dietary restrictions (e.g., vegetarian, vegan) we need to be aware of?
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Please Select
Yes
No
If you answered yes to the above question, please list your allergies and or restrictions below.
Section 3: Readiness & Intention (Crucial) These questions help us understand your commitment to the intense work involved. Please describe your primary intention for joining this retreat. Specifically, what cycle or pattern are you most ready to release? (2-3 sentences)
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This retreat focuses specifically on healing strained or estranged relationships with one or both parents (The Mother/Father Wound). In one paragraph, briefly describe where you are currently at in this healing journey. (E.g., Are you newly aware of the trauma? Are you already in therapy and doing deep shadow work?)
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We will be utilizing intensive modalities (Ancestral Work, Shamanic Journeying). Are you currently working with any of these modalities, or are you open and committed to engaging fully with them for deep emotional processing?
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This retreat requires a commitment to radical self-forgiveness, forgiveness of others, and releasing the victim narrative. Are you currently working with a therapist, coach, or spiritual guide? If so, for how long? (This helps us gauge your support system.)
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Confirmation of Readiness: Please confirm you understand that this retreat involves intense emotional work and is designed for women who are ready to release their pain rather than simply talk about it.
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Yes, I confirm I am ready and committed to deep emotional processing and healing.
Next Steps & Payment Preference: How do you plan to complete your investment? (No payment will be taken today; if we feel you are a good fit; you will receive an email with confirmation and a link to submit payment)
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Pay in Full (Requires payment upon acceptance)
Payment Plan (Requires a non-refundable deposit upon acceptance
Submit
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