Work That Reconnects & Holotropic-Based Breathwork Regenerative Mountain Retreat at University of Earth - Registration and Payment Form
Thank you for registering for this regenerative Mountain Retreat. Expand your capacity to connect with nature, spirit and your deepest self. When we realize our radical interconnectedness with all peoples and species, we become part of the Earth healing herself.  

Please fill out the following information and send in your payment as instructed. Also please fill out the Biographical Questionnaire. We look forward to our time together. We are so glad to be back in person!! Hurray!!  

Logistics: 
The University of Earth is located at 64274 CA-70, Cromberg, CA 96103, United States. The maximum number retreat attendees will be 20.  The U of E can sleep 16 people in double rooms (including two off-grid yurts) and 8 people in single rooms, offered on a first come basis. There are also spaces for you to bring your own tent and bedding as well. Please see the what-to-bring list that we will send out.

We will provide 3 vegetarian meals daily starting with Wednesday, Sept. 28th, dinner and ending with Sunday, Oct 2nd, to-go lunch. We ask people to arrive between 3-5pm on Wednesday so we can have dinner together at 6pm and begin our evening program at 7:30pm. We will end on Sunday at Noon with a to-go lunch provided.   

Covid - We are requesting that everyone take a covid test within 72hrs of the start of the retreat. Please send your results to Mutima Imani  at <thequeenmutima@gmail.com>  .  We will not be able to socially distance inside the dining area nor the Workshop Yurt. We will be outside as much as possible - weather and temperature permitting.

Gift Economy, Scholarships and Deposit:

The University of Earth is providing rooms at a steep discount to keep this retreat as affordable as possible.
The facilitators Constance and Mutima are offering their facilitation of the weekend on a donation basis.

Based on enrollment numbers we will be able to offer partial scholarships. Please inquire for scholarships if needed.

For more information or questions please contact Yulia Smagorinsky @ wtrspiraljourneyfdp@gmail.com 
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email *
Name *
Address *
Lodging I prefer is *
Scholarship Fund Donation. We want to offer scholarships to make this retreat accessible to all. Please donate if you can so others may participate.  Thank You!
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Please make a payment deposit of 1/2 your cost plus your donation to the scholarship fund. - Tenting (Total $755, Deposit $380 + scholarship donation); Share Room (Total $885, Deposit $445 + scholarship donation); Single Room (Total $985, Deposit $495 + scholarship donation). The final payment will be due on September 14th. Refunds will be available until Sept 14th - minus a $50 registration fee. *
My special needs request for a single is:  (There is a limited number of single rooms so we want to give priority to those who have special needs.)
For shared rooms we will put like genders together, unless you specify a different need or preference. Please indicate your gender:
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Please share any specific needs or preferences with regards to room-sharing:
Do you have any dietary restrictions that our vegetarian chef should know about? If you need to bring your own food, you may put it in fridges in the cabins.
For the Holotropic-based breathwork - the following health conditions will require a pre-interview with Rich Silver.  All who register will be required to fill out a medical form.
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Covid is still with us and we want to be as safe as possible. Please do a test within 72hrs before arrival. We will not be requiring masks inside and the indoor meeting space used for the workshop and the breathwork is equipped with anti-viral air filters.  We will be meeting outside often as well. *
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Partial Scholarship Request. - Please let us know the maximum amount you can pay. We want the retreat to be accessible to as many as possible.  Scholarships will be available based on total enrollment.
I understand I need to bring cash, checks or credit card to make donations separately for the  workshop facilitators Constance and Mutima as well as tips for the caterers. *
Are you attending this retreat as a prerequisite to the Spiral Journey Facilitator Development Program?
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I have filled out the Biographical Questionnaire at https://forms.gle/7ypFTQDDpTHkEsEm8
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Have you attended Work That Reconnects Workshops or Holotropic Breathwork before?
Thank you for registering for the retreat and your interest in the Work That Reconnects and building a thriving world for all.  Please let us know anything else you need to communicate.                                                                                
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