Breathe Pray Worship Retreat Inquiry Form

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This initial form is to let us know you are interested in our Breathe Pray Worship Retreat and give us some information about yourself.

Email *

First and Last name *

Phone Number *

Reason you are interested in the retreat? *

Divorce

Grief

Spiritual Trauma

Family/Generational

Committed to a healthy journey

All of the above

Other:

Is this your first retreat? *

Yes

Spiritual/Religious background

*things we should know- this is not a requirement, we just want to meet you where you are and respect where you have been.

Have you been doing any personal work already? If so, what?

Example: Therapy, spiritual direction, support groups, independent study, meditation, body work, etc.

Is there anything you are really hoping to do while on this retreat? *

Are there any food allergies we should be aware of? *

Are there any non-food allergies we should be aware of in case of emergency? *

I would like to contribute to the scholarship fund to help someone else come on a retreat *

Yes

Maybe

I would like more information on the scholarship fund to assist me in participating in this retreat *

Yes

Maybe

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