Hill Country Weekend Reset Application Form - August 2023
I'm so excited that you're joining me for this magical Weekend Reset! Please fill out this form to begin the process of reserving your spot. I will reach out to you within 24 hours of receiving your application to confirm your spot and arrange payment. Payment must be received within 48 hours of my follow-email or I'm afraid your spot will be released. If you have any questions at all, feel free to email me at: Alia@AliaJKhan.com! 

xoxx, 
Alia
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What's your full name?  *
What's the best email address for me to use to communicate with you?  *
Which Lodging Option are you choosing?  *
Which Lodging Option are you Choosing?  *
If you are choosing Double Occupancy (or more, for the Slumber Party Casa), please provide the name and email address of your roommate(s).
Which Pricing Option are you Choosing? *
What's your preferred payment method?  *
Any dietary restrictions or preferences that I should know about?  *
Is there anything going on with you physically, mentally, or emotionally that could affect your practice and/or that I should know about? (Injury, pregnancy, stress, grief, any recent major changes in your life, etc.) *
Emergency Contact Name + Phone Number *
What inspired you to sign up for this retreat? Do you have any goals or intentions for the weekend that you'd like to share with me? 
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