The Raw Connection Retreat 2 (registration form)

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Welcome to our second fully Raw Emotional Healing retreat! :)

To make this experience smooth for everybody we kindly ask you to answer the following questions about the food, accommodation and health.

Email *

Your Name *

Link to your Facebook profile :) *

Please mark going on the event, or if you prefer not to do that, than pleas give us a link to your social media account

What is your main motivation to join the retreat and what are the most important things for you? *

Choose the things that resonate with you the most and write us more in the "OTHER" box. This will help us understand your needs and adjust the program in a way that feels good for all of us. :)

for the community feeling

to make friends and connection

for emotional healing

the Raw diet and health reasons

to meet old friends

to have fun and enjoy

I'm having hard time and I need support

I come to help others and give support

Other:

Required

How did you hear about the retreat?

From a Friend or family member

from facebook advertisement

from one of the organizers

From Instagram

Other:

Would you like to stay 2 days longer to experience fasting? *

1 day of water fasting (Monday) and 1 day of juice fasting (Tuesday)

Yes

Maybe

Where would you like to sleep? *

Below prices are for the first 3 days. Additional costs apply for the 2 extra days.

Caravan/ Tent (bring your own): total cost 255 (early bird 225 euro)

2-3 person bedroom: total cost 275 (early bird 245 euro) *fully booked available only if someone cancel

Single Bedroom: total cost 300 (early bird 270 euro)

Special requests regarding food (allergies/intolerance/special diet etc):

Do you currently suffer or have you suffered in the past 3 years from a physical or mental illness that requires medication or professional support? If yes, please specify. *

Further support during the retreat:

In this kind of retreat we may go into a deep healing process that may take a long time, and require special care. As we are only two organizers we don't always have the capacity to take care of individual cases during the program. Therefore we recommend that if you are in a space of needing constant support, help, or feeling unstable, that you register for private assistance. We have specialists in emotional healing ready to support you during the retreat in case of acute emotional need, and also for voluntary private sessions. Price is 97 euro for the first 2 hours and 50 euro for each additional hour, with a maximum cost of 350 euro per day.

I want to book a session + 97 euro.

I may need but I'm not sure now.

Thanks, I don't feel that I need it.

Other:

More info / other requests:

Payment

You can send the full payment or a deposit* of 150 euro to this account:

Bank transfer:
Alsamman, Rami
DE67 1005 0000 1065 0592 36
pay with PayPal ( there is 6 Euro fee from PayPal)
https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=J896KDLV9VFTC

TERMS AND CONDITIONS, by registering you agree to the following
https://bit.ly/2EmcxbW

* the rest of the payment to be paid in cash at the time of arrival.

I will do the payment using *

Paypal

Bank transfer

Other:

A copy of your responses will be emailed to the address you provided.

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