Shadow Work Retreat Equity Seat Application

We're thrilled that you're interested in applying for the equity seat at the Shadow Work Retreat! The qualifications are simple:

~Make an income of $16,000 per year or less (add $5,400 for each dependent to that limit)

~Fill out this form

You'll hear from us on whether you've been awarded the seat on November 18th via email. The email will come from embodyhealing@proton.me around noon.

That's it! We hope to see you there!

Full Name

First NameLast Name

Email Address

example@example.com

Would you like added to our newsletter? We do not share emails or spam. You will receive no more than three emails per month, but usually it's one or less. This is the best way to stay in touch.

Do you meet the income qualifications to apply? If no, apply anyway. If no one within our income guidelines applies, you may still receive the seat.

Why should you be the person to get the equity seat? What does attending this retreat mean to you?

Herbs and essential oils will be used at the retreat. Please list any relevant allergies you have so we can avoid those. If you don't have any, please type none or not applicable.

A folding chair will be provided for the event. Is there anything else you need in the space, any other accommodations necessary to enable you to attend?

This retreat is NOT appropriate for those with active, severe trauma without support, those who are actively suicidal, or for those currently experiencing psychosis. This retreat is for personal enrichment and growth, and is not medical or mental health care. Shadow work can bring up intense emotions, discomfort, or past trauma. If you feel overwhelmed, destabilized, or unsafe at any point, please pause the practice and reach out for supportive services. Shadow work never justifies harm to yourself or to another. Embody Healing, LLC and David Gamble-Moore, M. Div., HP, Clinical EFT Practitioner, Herbalist can not accept liability for effects of the space or content of the workshop.

I understand and accept responsibility for my mental/emotional state and physical safety. I hereby release, waive, and forever discharge Embody Healing, LLC and David Gamble-Moore, M.Div., HP, Clinical EFT Practitioner, Herbalist from any and all liability, claims, demands, or causes of action arising out of negligence or any physical injury, illness, or damage I may sustain as a result of my participation in the workshop or use of herbal supports provided. I agree to indemnify and hold harmless the practitioner and company against any and all legal fees or costs resulting from claims brought by me or in my behalf.

Anything else you want us to know?

How did you hear about our workshop?

Thank you for applying! You will hear from us on November 18th.