the haven retreat
i am so beyond excited to connect with you in such a beautiful way! with the following survey, i will be able to get a better understanding of you + your plans, so that my partner and i can prepare accordingly :-)

once you have submitted your form, we will get back to you in up to 5 days to provide you with the next steps!
Sign in to Google to save your progress. Learn more
Email *
what is your name? *
how old are you and what are your pronouns? (18+) *
what is your social media? *
what is your primary phone number? (we will communicate through imessage or whatsapp!) *
do you speak spanish? *
are you traveling alone or with an additional person? *
if you are traveling alone, would you like to have a solo experience, or are you open to being paired up with someone? (note: being paired up is a possibility, but not guaranteed!)
Clear selection
what dates you would like to come for? *
how many days would you like to come for? (you're welcome to suggest another set of dates, and we can discuss the details) *
what price resonates with you? // refer to the question above for the applicable pricing *
do you have any allergies/dietary restrictions? what are they? (we can easily accommodate a vegan diet! we cannot accommodate a keto diet) *
what are you looking to gain from this experience? *
do you have a spiritual practice? what does it look like?
why do you feel called to this retreat? what lights you up about it? *
lastly, what are a few things you are grateful for? *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of jasmine mariposa. Report Abuse