October 2022 - Divine Masculine Immersion Questionnaire

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Email *

Name *

First and last name

What is your Age? *

Phone number *

Are you willing to be challenged, vulnerable and to go outside of your comfort zone for growth, healing, self discovery and elevation? *

Yes

What are you desiring to gain most out of this Divine Masculine Immersion? *

What are you willing to let go of?

How did you hear about this retreat? *

Experience with Kundalini Yoga? *

New to Kundalini Yoga

Practiced a Few Times

Practice Regularly

Practice Occasionally

Any Prior Experience with Mens Work? If so please briefly describe. *

Facebook Name? (for our Secret Group post-retreat) *

Instagram Handle? *

Where do you live? *

What are your Dietary Restrictions? (For Our Chef's Food Prep) *

Do you have any Medical Conditions or Injuries? (If so please describe) *

Camping Set Up: *

I am bringing my own camping equipment

I will buy or borrow some local camping gear

Required

Are you interested in staying the Bonus Day Sunday Night and Leave Monday Afternoon/Evening? *

Yes

Other:

Are you able to arrive on time on Thursday between 12pm and 2pm and be ready by 2pm? *

Yes

Are you willing to participate in a large group retreat during the Covid-19 Pandemic? *

Yes

Any Notes or Comments? (Optional)

Submit

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