Disconnect to Reconnect Retreat
First of all YAY! We are super stoked that you are interested in our retreat, it is really going to be amazing and will give you a one of a kind experience to master those healthy habits and show up as your true, authentic self, busting limiting beliefs, focusing on self care and really stepping INTO YOUR POWER.

Submission of this application form is the first step to apply for the retreat. Upon revision, we will contact you and once payment is submitted, your seat will be secure and you have 1 of the 8 spots for our VIP Retreat.

Please answer all the questions below.
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Email *
Name *
Will you be attending alone or with a friend? *
What is your preferred method of payment *
I am aware that ALL funds need to be paid 1 week prior to the event. *
I am aware that there are no refunds *
Do you have any food restrictions or allergies? If yes, please specify. *
I will adhere to the appropriate Physical Distancing protocols that will be in place? *
Which workshop/activity are you most looking forward to? *
Required
I am aware that this is a digital detox and I will be disconnecting from cell phones, computers, social media etc (there are exceptions regarding work/family) *
I understand it is encouraged to participate in all events, but not mandatory. *
How excited and ready are you for this VIP retreat? *
Not at all
TAKE MY MONEY, I am ALLLL IN
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