good grief retreat 2026 registration form

good grief Retreat 2026 Registration

We're so glad you'll be joining us for this retreat! Please fill out the form completely. If you have any questions you can email us at flutterbycincinnati@gmail.com.
Introduction
Date: Saturday, March 14 2026

Location: Covington Church House, Covington Kentucky

Time: 10 am - 8 pm

This will be our first annual good grief retreat, hosted by flutterby cincinnati, and we are looking forward to spending time with you. Before you begin, here is a little more information on our retreat:

Our retreat is open to all parents, individually or as a couple, who have experienced pregnancy or infant loss. However, we do believe it may be most beneficial for those who are at least 6 months or more from their loss, as this may help reduce the likelihood of feeling overwhelmed by emotions in the earlier days of grappling with such a loss.

This retreat isn’t tied to any one religion or belief system. We welcome everyone, whatever your faith, spirituality, or if none of that resonates with you. What matters most is that you're here, and you're not alone.

You'll be supported by a mix of people: some are trained professionals, and some are fellow parents who’ve experienced similar losses.

Our retreat day will be group sessions, activities that get you moving, and will also include a light breakfast, lunch, and dinner.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Name of Spouse/Partner

First NameLast Name
Phone Number of Spouse/Partner
Please enter a valid phone number.
Number of people attending*
Retreat is open to both individual loss parents as well as couples.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pregnancy/Infant Loss Sharing
Please share with us your pregnancy/infant loss(es); please include years, names/nicknames, and anything else you would like us to know.*
What is your baby(ies) birthday?*
What songs remind you of your baby(ies)/pregnancy, or have been helpful in your healing?*
Dietary Information
Food Allergies/Sensitivities*
Favorite Go-To Comfort Foods*
Favorite Way to Caffeinate*
Code of Grace Statement

Please read and sign; if there are two people attending, please both sign in the box.
Thank you for being here and trusting us with your story. We know that grief is deeply personal, and everyone carries it in their own way. Each of us also brings our own beliefs—spiritual, religious, or none at all—and that beautiful diversity is something we value here.

To help us all feel supported and connected, we ask that you:
- Come with an open heart, kindness, and respect for everyone’s journey.
- Refrain from criticism, argumentative behavior, or debate about others’ beliefs or ways of grieving and/or coping.
- If things get tense, we may have the group to take a break from the session to help keep our space peaceful for everyone. We will also have designated areas people can go to if they feel overwhelmed or upset and need a minute alone.
- None of the sessions or activities are mandatory, we are here for YOU, and if you is not feeling it, it is totally ok to skip a session or opt out.
- Honor the courage it takes to be vunerable by keeping what’s spoken here confidential—please don’t share stories or details outside this circle.
By joining us, you acknowledge and agree to honor this commitment to respect, kindness, and confidentiality throughout the retreat.

Thank you for helping us create a compassionate community.
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Shirt Order
Please choose your shirt size(s); limit one per attendee. Shirts are long sleeved Bella & Canvas cotton.*
Emergency Contact
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Registration fee - IndividualFee helps covers three meals, drinks, snacks, tshirt, and venue.
$40.00

Registration fee- CoupleFee helps covers three meals, drinks, snacks, two tshirts, and venue.
$70.00

Total

$0.00
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good grief Retreat 2026 Registration

Introduction

Pregnancy/Infant Loss Sharing

Dietary Information

Code of Grace Statement

Shirt Order

Emergency Contact