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11:11 Mountain Goddess Retreat Interest Form
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Email
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Your email
What is your first and last name? Please also list any preferred name that is not your legal name.
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Your answer
What is your phone number, email, and home address?
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Your answer
What is your date of birth?
Your answer
What is your gift?
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Bringing a vibrant energy into the room
Supporting others
Resilience and inner stregnth
Staying balanced
Spontaneity and optimism
I'm most proud of:
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my ability to love deeply
my career and achievements
my creativity
my mind
my adventurous spirit
my self-awareness
What is your favorite flower/plant?
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Your answer
All rooms include 2 twin beds. Select the room option you are interested in:
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OPTION 1: $850 Share a room with a Goddess you select with each of you sleeping in your own twin beds.
OPTION 2: $800 Share a room with a Goddess selected for you with each of you sleeping in your own twin beds.
OPTION 3: $1200 Reserve your own room with 2 twin beds all to yourself.
If you selected Option 1, please write the name and email address of the Goddess you will room with below. Note that you both must pay in full to reserve your room together.
Your answer
What style of yoga do you typically practice and how often?
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Your answer
Where do you regularly practice yoga?
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Your answer
What types of sessions would you want to participate in on retreat?
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Power Vinyasa
Yin Yoga
Restorative Yoga
Yoga Nidra
Yoga Sculpt
Pilates
Dance
Gentle
Deep stretch
Meditation
Journaling
Mindfulness Exercises
Arm Balances/Inversions
Book circle
Required
What are you looking for in a yoga retreat? (Relaxation, introspection/self-discovery, physical reboot, empowerment, connection, nature, self-care, community/friendship, deeper understanding of yoga, etc.)
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Your answer
How did you hear about this retreat?
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Your answer
Thank you for your interest! Retreat Leader, Sherry Lankford, will be in touch!
Send me a copy of my responses.
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