Sovereign Initiate Retreat Application
Please review and complete this application for review.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name and Phone Number
*
Have you been to Mount Shasta before?
Do you have any medical conditions, injuries or allergies we should be aware of? If yes, please specify. Please specific if you are on any medication related to above.
Do you have an established meditation / yoga / energetic practice?
Do you have any experience with astral terrain ie. entities/attachments - please explain
Do you have any psychological issues - ie. chronic depression, anxiety, schizophrenia, bipolar, personality disorder etc. and are you taking any medication?
Do you understand this is an intermediate to advance retreat involving more technical terrain and steep incline with high-level energetic mastery training? This is not for beginners - it will be expected that you are an avid hiker and have done a lot of spiritual / trauma-based healing already. (Yes/No)
By signing below, I confirm that I have read and understood the terms and conditions for outdoor activity participation.
*
Date of Agreement
*
-
Month
-
Day
Year
Date
Submit Agreement
Submit Agreement
Should be Empty: