2024 Retreat Registration Form

A retreat experience spread out across the seasons, weaving together herbal wisdom, foraging, gardening, earth (re)connection, community, healing & personal growth.

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電子郵件 *
Your First and Last Name: *
Your Email address: *
Your Phone Number: *
Your Emergency Contact(s) First & Last Name: *
Emergency Contact(s) Phone Number: *
Retreat(s) for which you are registering? *
必填
If participating in a Seasonal Retreat, will you need to miss any days?  If yes, please include the dates and times below. *
Do you have any allergies?  If so, please name them below and if no, just write no or n/a. *
Do you have any food sensitivities or intolerances?  If so, please list them below and if no, just write no or n/a. *
We will be spending time outdoors in natural spaces, exposed to pollen, bugs, mud, water, sun, wind...maybe even light rain at times (we are proactive in our planning, monitoring weather and do our absolute best to provide the safest nature connection experiences).  Do you have any questions or concerns around our time spent outdoors? *
Our time together will involve sitting, standing, gentle movement, walking, bending and kneeling (plant tending/harvesting).  Do you have concerns or anything you'd like to share around mobility?   *
What is your experience with meditation?  Do you enjoy meditation? Are there aspects you struggle with, or aspects which come to you with ease?    *
Herbal preparations are made with water, vinegar, alcohol, glycerine, honey, sugar, maple syrup.  Do any of these present a concern for you?
 *
What is your current level of herbal experience / education?  Please select from the following: *
必填
Name one or two things...a goal or what you are hoping to walk-away from this experience with? *
Do you have questions or concerns you'd like to share/discuss? *
Cost & Payment Options
Select payment boxes that apply to your chosen Retreat & method of payment...leave the rest blank.
1 - Day Retreat(s)
Each 1-day Retreat has a sliding cost of $99  - $125.00.
How much will you pay from the sliding scale above?
How would you like to pay for your 1-day Retreat?
Seasonal Herbal Healing Retreat(s)
Sliding Scale $395 - $495 per season (spring, summer, fall)
You choose the cost of your retreat from the range above.  Use the sliding scale while taking into consideration your income and financial stability and/or if you will miss any of the scheduled days (we ask not to miss more than one).  We do not ask for proof of income.  Choose the amount that feels best for your life and circumstances.  

Payment Options include:
A.  Pay in Full
B.  Payment Plan ($100 due at time of registration)
How much will you pay from the sliding scale above?
A.  If paying in full, how would you like to pay?
B.  Pay by payment plan (part 1/2):

$100 is due upon registering to hold your spot, with the remaining balance spread out over time.  Let us know below what type of payment plan you have in mind.
Pay by payment plan (part 2/2):
For the $100 due now...how would you like to pay?
Once you submit registration, we will be in touch to confirm and finalize payment...and from there, more event details.  If you have any questions, don't hesitate to reach out through the contact form on the website.

In Gratitude and Appreciation, 
Tasha, Robecca, Karen & Deanna
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