Reignite Your SPARK Retreat
Hello! Welcome to the SPARK wellness retreat "wellness intensive" experience! The first step is getting us acquainted with you. Take some time to fill out this questionnaire to ensure that your experience at the retreat suits your needs and allows for you to have an individualized experience. We want to be sure that this goal is achieved, so be sure to answer each question to the best of your ability. Thank you in advance for your openness to share! 

Once you submit this questionnaire, you will receive a confirmation email outlining the initial details to get you setup and ready for October. You will be prompted to pay to secure your spot. The retreat cost is $1,500. You will have the option to pay in full or set up a payment plan with Paypal. Your payments will be expected to be paid in full by July 7th. For those of you who are among the first 3 to sign up, you will receive 10% as a thank you for jumping on board.  *** Please note if you are paying in installments, your first payment must be at least $500 to secure your spot. Thank you for allowing us to join you on your journey of wellness! 
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Email *
Name *
Phone number *
Address *
What is your date of birth? *
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List food allergies/dietary restrictions. Please indicate "N/A" if this does not apply to you.  *
List favorite foods/snacks.  Please indicate "N/A" if this does not apply to you.  *
List general allergies (including scent, animal, and outdoor allergies).  Please indicate "N/A" if this does not apply to you.  *
Please share health conditions, medications taken, and/or medication side effects that would help the team to support you in the event of an emergency. Please indicate "N/A" if this does not apply to you.  *
How many people will be attending in your group?  Please indicate "N/A" if this does not apply to you.     *
Names of participants in your group.  Please indicate "N/A" if this does not apply to you.  *
Sleeping accommodation preference *
What should your roommate know about you when it comes to sleeping and/or being your roommate? *
Marital Status *
How many children do you have, if any?
What are your top 2 or 3 favorite colors? *
What is your favorite saying, hobby, and/or animal? *
What areas of wellness/self-care do you consider to be strengths of yours? *
What areas of wellness/self-care would you like to grow in? *
What are you hoping this retreat will re-spark in your life? *
How did you hear about the retreat? *
*Included in the cost for the retreat are opportunities for one-on-one coaching.  Please indicate if you have ever received any life coaching or therapy. If so, please include the length of time you received these services, as well as any benefits/drawbacks to these services. * *
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