September 25-27 Fall Women's Wellness Retreat Registration Form

September 25-27 Fall Women's Wellness Retreat Registration Form

Women's Wellness Retreat September 25-27, 2026 A Burnout Prevention Weekend Retreat For Nature Loving Women Of All Ages
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Mobile Number
Format: (000) 000-0000.
Emergency Contact Number
Format: (000) 000-0000.
Emergency Contact Name
Hello beautiful souls! Here is your retreat registration. To help you complete this registration, please ask us to email you a doc called "Offerings for September 25-27 Retreat". This gives you more details to help you design your retreat experience. Please read it first before making your retreat selections. As you are designing your retreat, remember to tune into what you are looking to get from your retreat. You get to be your own leader in choosing how to spend your time. Resist the urge to sign up for everything. Do you need quiet time alone? Do you need to connect with other women? Do you need to move your body? Do you need to slow down or be still? Would you like a balance of both? Please remember that the private treatments (massage, osteopathy, acupuncture, myofacial release, reiki) are additional cost to be paid to your provider on the day of your treatment -some treatments may be a claimable expense if you have health insurance benefits. PLEASE ONLY CHOOSE ONE TREATMENT AT THIS TIME. There is a space below to make a request for a second treatment if there are any available after registration is complete.
Please write a few words about what you hope to get from your retreat experience
It is preferable (however not mandatory)that everyone arrive around the same timeframe and are able to stay for the duration of the retreat versus coming late or leaving early etc. Please confirm below by typing "yes" that you are able to commit to the timeframe. Arriving between 3:00-5:00pm on Friday September 25 and staying until approximately 4:00pm Sunday September 27. Please use the space below to confirm
Friday 8:00pm - 9:00pm
Saturday 7:30am - 8:45am
Saturday 9:00-10:15am
Saturday 10:45 - 12:00am
Saturday 1:00 - 2:15pm
Saturday 3:00 - 4:30
Sunday 9:00 - 10:15am
Sunday 10:45am - 12:00pm
Sunday 1:00 - 3:00pm
Write your name again below if you would like to have a second private treatment (if available)
Please choose the accommodation option that feels most comfortable for you. You’ll have your own bed, with shared spaces such as bathrooms, living rooms, and kitchens to enjoy together.For each bed, we provide a mattress protector and fitted sheet. Please bring your own pillow and sleeping bag or comforter.A quick note about the Bunk House: it does not have an attached bathroom, but there is a nearby outhouse, and you’ll also have access to two indoor bathrooms—one in the Beach House and one in the Jack Pine Cottage.If you love having your own private space and feeling closely connected to the land, you’re also welcome to bring your own tent (or borrow one) and set it up in our beautiful riverside tenting area. Beds located in the Jack Pine Cottage are reserved for participants with medical needs that require overnight access to a bathroom or electrical plug-ins. Often not all 4 beds are needed for medical reasons and so if you would like to be considered for a Jack Pine bed once registration is complete please note this in the space below.
Fill in the blank. The song that always lifts my spirits is… blanks
Please list any food allergies, dietary restrictions/preferences
Would you consent to your email being included in group emails to all registered participants?
This retreat honours rest, agency, and the nervous system’s need for choice. Photography is approached with the same intention. Please select the statement that best reflects your preference.
Please use this space to note any questions, concerns, or accommodation requests you’d like to share. I can connect with you by phone, if needed, to discuss how best to support you in having a deeply restful and nourishing retreat experience.
Retreat Payment:The total cost of the retreat is $625 + HST ($706.25).To reserve your space, a non-refundable deposit of $100 is required. This deposit secures your accommodation and private treatment & allows us to begin preparations for the group.If it feels supportive, you’re welcome to choose a 4-installment payment plan of $176.56 x 4. The full balance is due by September 1, 2026. Payment can be made via e-transfer to:wildgroundedretreats@gmail.com Acknowledgement & Consent: I have taken time to read the information above and understand the payment policies for this retreat. By typing my name below, I am confirming my agreement and my intention to participate with care and clarity.
Retreat Cancellation Policy: We understand that life can be unpredictable, and we aim to balance compassion with the practical realities of retreat planning.The $100 deposit is non-refundable. Cancellations made on or before September 1, 2026 will receive a refund of any payments made minus the deposit. Cancellations after September 1, 2026 are non-refundable, as retreat costs and accommodations will have been finalized. If you’re unable to attend, you are welcome to transfer your spot to another person (with prior notice), or we’re happy to explore applying your payment as a credit toward a future Wild Grounded retreat. Thank you for understanding and for honouring the care and energy that goes into creating this experience. If you have questions or would like to talk through what feels right for you, please don’t hesitate to reach out. Acknowledgement & Consent: I have taken time to read the information above and understand the cancellation policies for this retreat. By typing my name below, I am confirming my agreement and my intention to participate with care and clarity.
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