Sacred Earth Retreat Application

The Sacred Valley is calling you...

The Complete Registration Process is as follows:

1.  Apply! Approval email with more information and Terms & Conditions will follow.
2. Carefully read the Terms & Conditions PDF. Print the document, initial each page and sign the last page.
3. Select the payment schedule that works for you!
4. Upload the initialed and signed document and return via email.
5. Pay your non-refundable deposit of $500.00.  You will receive an invoice. 

Please complete the following form with honesty and from your heart.

Name *
If different than Physcal Address above
What do you hope to accomplish, experience or learn?
What do you hope to take away from the retreat?
This may include physical adjustments, savasana releases and Reiki energy work.
Do you currently or do you have a history of any of the following conditions? *
Please check all that apply. Please check "none" if applicable.
Health, Fitness, Wellness *
Health, Fitness, Wellness
I am physically healthy
I am emotionally healthy
I am mentally healthy
I am physically fit
I am able to participate in moderate exercise, such as hiking and yoga, every day for a week
I am happy with my overall health, fitness and wellness
No? I will match you with a roommate of the same gender.