Reclaim Your Wild Terrain: an Erotic Embodiment Cauldron for Women :: Application
Welcome!!
Please set aside 10-15minutes where you will be undisturbed and can take the time to drop in and complete this application process. This is meant to be a space for you to share more about what your desires are for the program and to determine if the container is a good fit for you. If you have any questions please reach out to: serpentandrosetantra@gmail.com 

Big love,
Caity

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A note applications are the first step and do not guarantee your spot in the program. To confirm your place in the program you will need to send in your non-refundable deposit and set up a time to connect on a call with Caity. Deposits can be sent via Venmo to: 9148067962 @serpentandrose. Please reach out to serpentandrosetantra@gmail.com to connect directly.
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Email *
Name (first + last) *
What is the best email address to reach you at? *
What is the best phone number to reach you at? *
Where are you located/traveling from to attend the class? *
What's your gender identity and sexual orientation? Please note this class is open to folks of all sexual orientations, however given the nature of the teachings and practices I ask that folks are biologically female. *
How did you hear about this program? *
If you could look back on this program and see that you received the thing you wanted/desired the most in your life, what would that be? Even if it seems impossible in this moment... *
Knowing what you want/desire out of this program, what is your intention/vision as you step into this container? *
What would feel like success at the end of this program for you? *
Describe to us the embodied vision of the YOU leaving the program with that success. *
What resources and support systems do you currently have in your life that you can lean into during this course? Please share more below - for example: working with a therapists or somatic practitioner, supportive friends, family, partners, taking time off from work, etc. *
Please note: evocative material, including past trauma can arise when engaging in embodiment work and relational healing. This work is therapeutic and deeply healing, but it is not therapy. I encourage clients to have be supported additionally by therapy, counseling and/or somatic practitioners when engaging in deep practice. Are you currently enrolled in therapy? Have you worked with a therapist before? *
Do you currently have or in the past have had any diagnosed or undiagnosed mental health issues (anxiety, depression, bipolar, border line personality, etc.)? If so, what support systems and practices do you engage with to manage the healing process? *
Do you currently or in the past have you taken any medications for psychiatric diagnosis? If so can you please share the dates on which you were/are on medication for and for what diagnosis? *
Have you in the past experienced trauma or are you currently in the process of trauma healing? (PTSD, sexual trauma, break-up, loss of a loved one, etc) If so, what support systems and practices do you engage with to help manage the healing process? *
Are you prepared to financially invest in the program? Early bird tuition is $525 (until June 21st). Full tuition after June 21st is $625. Payment plans are available on a case by case basis *
Are you available to attend all the live calls from 5:-8pm PT on Wednesdays? Classes will be on 7/6, 7/13, 7/20, 7/27, 8/3, 8/10 . If you need to miss a class please let me know which one(s). *
Are you interested in additional 1:1 coaching work with Caity as a part of your program experience? *
Are you prepared to engaging with the material and practices outside of our sessions? *
Please let me know your vaccination status and if you are boosted. You can email a picture of your vaccination card to serpentandrosetantra@gmail.com *
Have you scheduled your intake call yet with Caity? If not, please book a call time at serpentandrose.as.me/somatic and please make a note in the intake that you'd like to discuss the course! *
To complete your application please send in your deposit of: $287.50 (for early birds) or $312.50 (for full price tuition) via Venmo to @serpentandrose or 9148067962 *
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Payment + Refund Agreement: I understand that once enrolled in the Course if I choose to withdraw from the Course, I am still responsible for paying the full tuition, regardless of my choice to participate or not in the Course. If you withdraw from the Course before the first class (by July 6th) you will receive a refund of 25%. If you withdraw from the Course at any time after July 6th, 2022  you will not be eligible for any refund and you will still be responsible to complete your payment plan if all funds have not been paid in advance. I understand that exceptions may be made on a case-by-case basis and in the case of qualifying extenuating circumstances. *
Thank you SO much for taking the time to fill out this application. Is there anything else you'd like to share or questions you have about the program? I look forward to talking to you on our intake call and seeing you in the circle soon! *
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