Beautifully Flawed Retreat 2026 Attendee Application

Beautifully Flawed Retreat 2026 Attendee Application
The Beautifully Flawed Retreat will be held Monday, October 12, 2026 – Thursday, October 15, 2026 for girls ages 15-26 on the beautiful island of Kauai.

APPLICATION DEADLINE IS THURSDAY, JULY 9
APPLICATION INFORMATION:
I am a:
What year(s) did you previously attend the Beautifully Flawed Retreat?
GENERAL INFORMATION:
Applicant Name

First NameLast Name
Please note that email will be our MAIN FORM of communication with you. Please enter an email address you or your parent/guardian will regularly check and add info@beautifullyflawed.org to your contact list to ensure you will receive our emails.
Who will be the primary contact for the retreat information?
Parent / Guardian Name

First NameLast Name
Parent / Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Main Contact Email Address
example@example.com
Applicant Birth Date

MonthDayYear
Applicant Current Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Phone Number
Format: (000) 000-0000.
TELL US A LITTLE ABOUT YOURSELF:
What is your limb difference? Ex. left arm below the elbow, right leg above the knee, etc. (This helps us plan accordingly)
Please share the story of your limb difference.
Who or what inspires you?
Would you consider yourself a Christian or a person of faith?
Why do you want to attend the 2026 Beautifully Flawed Retreat?
Please remind us the story of your limb difference and share an update about yourself.
Why do you want to come back to the Beautifully Flawed Retreat?
If accepted as a retreat attendee, will you require a family member or other person to support and assist you during the retreats? If yes, please explain the level of assistance needed.
How did you hear about the Beautifully Flawed Retreat?
Is there anything else we should know, or that you would like to add?
Applicant Signature
Are you currently a minor under the age of 18?
Parent/Guardian Signature
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Relation to the Applicant
Applicant Photo

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Beautifully Flawed Retreat 2026 Attendee Application

APPLICATION INFORMATION:

GENERAL INFORMATION:

TELL US A LITTLE ABOUT YOURSELF: