Intuition Activation with the Elements -- Women's Retreat @ Potter's Farm (August 1 - 4, 2024)
Hello! We're so excited for you to join us at on the sacred land of Potter's Farm for soul alignment, grounding, and empowering sisterhood.

To register and reserve your spot, please complete and submit this form with your deposit. Space is limited. First come first serve. If you are new to Mother Lotus Retreats, we will reach out to schedule a brief phone call so that we can share more about the retreat and answer any of your questions. 

Early Bird Registration closes on 5/1/24. 

If you have any specific questions, please email motherlotuslove@gmail.com. We look forward to hosting you!
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Full Name *
Email *
Phone Number *
Tell us a little about you. Why are you pulled to this retreat? What do you want to get out of this experience? *
Choose your accommodation choice. (Early bird rates end on May 1st) *
If you'd like to request to share a room with someone, please list their name here. (They will need to fill out this form as well.)
Do you have any food allergies/aversions or dietary restrictions? We will be serving vegetarian meals at the retreat. If you need animal protein in your diet, please let us know.  *
Would you be interested in getting a massage during the retreat? (This will be an additional cost and you will pay the therapist directly.) *
How will you journey to Potter's Farm? *
Completing this form does NOT reserve your spot. Please send a $500 non-refundable deposit to complete your reservation.

Payment Options:
Venmo: maureenz0304
Zelle: motherlotuslove@gmail.com
Checks: please make checks payable to Mother Lotus LLC and send to 546 Welch Circle, Lake Barrington, IL 60010
Cash

Your deposit amount: *
Payment will be sent via: *
How did you hear about this retreat? *
Other comments/questions:
NOTE - By signing up, we will automatically add you to our mailing list so you can be updated on upcoming events and offerings. If you do NOT want to be included on the mailing list, please email motherlotuslove@gmail.com. 
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