Elements Retreat
Hello dear soul, Thank you for your interest in this retreat. This retreat is for those on a spiritual path and for those that want to deepen their intuition. If you have not worked with Mother Lotus before, we will schedule a quick call to connect and make sure this aligned to what you are seeking. 

To register, please complete and submit this form. After we receive your submission, you will get a confirmation email with information on how to make a deposit to hold your spot. (Space is limited. First come first serve.) 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 *
Have you worked with Mother Lotus before? (e.g. 1-1 session, reiki, women's circle, class, workshop, retreat, postpartum doula service, etc.) *
Tell me a little bit more about you and where you're at on your spiritual journey. *
What are you wanting to get out of this retreat experience? *
Choose your accommodation choice: (first come first serve) *
If you are sharing a room, please share the name of the person you are sharing the room with (They must complete this form as well.):
How are you planning to get to Potter's Farm? (Depending on what people do, we can coordinate travel schedules to see where we can carpool, etc.) *
Do you have any food allergies/aversions or dietary restrictions? *
Group excursion preference for the element of water: *
Would you be interested in getting a massage during the retreat? (this will be an additional cost of $70 for 60 minutes) *
How did you hear about this retreat? *
Other questions/comments
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