Country Retreat Application Form 🌲🌿

Country Retreat Application Form 🌲🌿

Please fill out this form to apply for your 121 retreat - (The Deep Space)
This country retreat is a private & intimate retreat 1:1, to properly pause, breathe & come back to yourself, deeply immersed in nature.

Over 2 nights, you will be supported through a deep immersive day of embodiment work, spa treatments, along with breathwork, rest & time in nature.

I keep this experience private & intentional, so I work via an application process to make sure this is the right fit for you.

The locations are in South East Hampshire | UK nr Four Marks/Alton. A 1 hour & 30min train journey from London.

A full presentation & info will be shown after your application is submitted.
Full Name

First NameLast Name
Contact Number
Please explain what has been going on in your life or within yourself that has led you to this personalised 1:1 retreat?
Why are you interested in attending the 121 retreat?
What do you notice right now within your body? When you slow down and really tune in, what comes up?
How are you currently feeling emotionally, mentally & physically?
If these 2 nights gave you exactly what you needed, what would feel different afterwards?
Have you experienced breathwork. Embodiment, or any kind of nervous-system work before?
Is there anything physical, or mental health related you'd like me to be aware of before we connect?
Do you have any prior retreat experience?
When would you ideally be looking to stay?
Please share any special requirements or accommodations you need & what would help you to feel safe, comfortable & supported during a 1:1 retreat like this?
This is a private 1:1 retreat experience, personalised to you.

A £320 non- refundable* deposit is required to secure your booking*. So please make sure this is aligned to you.

This will only be taken once we have a video call to share more info on your stay/you will then be shown a presentation of your stay where all questions can be answered.

*(non-refundable after 14days)

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🤍 Thankyou for sharing your answers with me. Ill read through & be in touch soon to arrange a video call if it feels like the right fit.

Jade x
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