Goddess Retreat Application Part 2

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We want to ensure all attendees are a good fit for this experience and retreat. Please fill out this form with full transparency. It will not be published anywhere, it is only for the facilitator (Samantha) to read and have a good background knowledge on each attendee so we can make this the best experience possible. There are only 6 spots available for retreats - on first come, first applied, first paid basis. 🤗✨🥰

Your Full Name *

Phone Number (to receive updates)

Your Email (receive updates)

Do you have availability to attend September 26 - 30?

Yes! September 26 - 30 preffered!

No. September 19 - 23 would work better for me.

I'm currently available both weekends (Sept 26-30 OR Sept 19-23)

Clear selection

What’s your IG @ handle? (So I can DM you) *

What excites you most about this retreat? Why do you want to attend this retreat? *

If you could wave a magic wand, what are 3 things that you would ask to manifest right now? *

What brings up feelings of nervousness, anxiety, or hesitation in your life right now? *

Have you been on a retreat before? If so, when and where? Anything specific that you did or did not like about it? *

Are you interested in participating in a psilocybin (magical mushroom) ceremony on this retreat? ✨🍄 *

Yes!

Not my thing.

What is psilocybin? (We can chat about it via phone or text to answer this question)

What is your fitness level for hiking? This only determines the types of hikes that will be on the schedule, your answer here will not prevent you from being accepted. We just want to make sure everyone can do everything on the schedule. *Please select all that apply!* *

I've never hiked before!

I have some experience with hiking!

I love to hike! Bring on the incline!

I'm not in very good physical / fitness shape

I'm good physical / fitness shape

I workout (HIIT/Run/Weight Train) multiple days a week

I don't workout (I have a very sedentary lifestyle, I walk)

I do low impact workouts (yoga, walking, pilates, swimming)

Required

How did you hear about this retreat? *

Refund & Cancellation Policy: I (the attendee) understand that this retreat investment is 100% NON-REFUNDABLE and NON-TRANSFERABLE! I will purchase travel insurance (we will provide information - it's very inexpensive!) to cover me in case of cancellation. Having insurance will cover all having covid, death in family, emergency, change-mind, etc and Maniscripting.com is not responsible nor will refund for any reason. It will be my responsibility to claim insurance if for any reason they cannot attend. I also understand that I cannot transfer my spot to a future retreat and that I must attend the retreat I register for. Thank you for understanding and agreeing by selecting YES below.

YES - I understand my purchase is non-refundable and it is my responsibility to purchase travel insurance

NO - I do not agree (selecting this will void your application)

Clear selection

Release Form: I understand that I am solely responsible for my health and safety, and will not hold retreat leaders responsible for any loss, injuries, or illness that may occur. I will consider the interests of the group, but know that I may participate in as many or as few of the activities as I like. Please note: To insure a safe and sacred space, the retreat facilitators do not provide alcohol, but if some guests should have their own alcohol, please consume moderate, mindful drinking. Thank you for understanding and agreeing by selecting YES below. *

YES - I understand the terms.

NO I do not agree (selecting this will void your application)

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