Grief is Love Retreat Registration Form

Grief is Love 2nd Annual Retreat November 13th- 15th

Glynwood Center, Cold Spring, NY
Marisa Renee Lee is a renowned author, speaker, and advocate dedicated to helping individuals navigate the complexities of grief. Through her work, she offers tools for healing while embracing the full spectrum of human emotion, including joy. Join Marisa and colleagues for a restorative and joyful weekend in New York’s picturesque Hudson Valley where you will focus on acknowledging and moving through the worst of loss so you can learn how to live with it.
YOUR CONTACT DETAILS

To ensure you receive important updates and exclusive event information, please provide your contact details below.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please provide an emergency contact
Do you have any medical or dietary restrictions?
What are your pronouns?
How do you identify in race and gender?
If you have social media what is your handle?

Retreat Details
How did you hear about the retreat?
What motivated you to apply for this retreat?
What do you hope as a takeaway from this weekend?
Can you share who you lost and when this loss occurred?
Have you attended any grief support groups or therapy since your loss?
How do you cope with your grief day to day?
Have you had any suicidal thoughts, issues with depression, or substance use disorder?
Tell us a bit about yourself.

Event Details
Accommodations are determined on a first come first serve basis. Most rooms are private, but there is one shared suite with two queen beds available that comes with a discount of $100. Glynwood has three separate buildings on the property where housing and retreat programming will take place. The Perkins House, which is where programming will take place, The Farmhouse, and Appledore Cottage. All inclusive retreat fee is $2000 with a $500 security deposit due when accepted.
Would you be interested in sharing a room for a discount (limit 2 participants)?
Do you have any mobility issues that would require ground floor accommodations or being housed in the main retreat building to limit walking?
Would you be interested in participating in any yoga, physical fitness, breathwork or Traditional East Asian Medicine workshops or sessions during the retreat?
Do you have any special requests, accommodations, or comments for the retreat staff?
Thank you for your interest in the Grief is Love retreat! We will respond to you within 5-7 business days for the next steps! Email griefisloveretreat@gmail.com with any questions!
Should be Empty:

Grief is Love 2nd Annual Retreat November 13th- 15th