Thank you for taking the time to fill out the application for the 1:1 retreat experience.

Please note, the retreat it self will be within 3 months of the deposit being placed, on our connection call, we will discuss dates + get them pencilled in.

I will been touch within 1 working days to book in a call for us to connect + discuss any questions.

Name

First Name

Last Name

Can you tell me what has drawn you to this retreat experience?

What do you feel our focus + intention will be over our time together?

Tell me more about yourself, your journey up until this point and what your relationship with your body is currently and historically.

Do you have any dietary requirements?

Please state below if any of the following apply to you: are you pregnant or planning to get pregnant within the time frame we will be working together? Do you have epilepsy, schizophrenia, bipolar, current drug or alcohol addiction, a history of recent psychosis? If yes to any please share more below.

The fee for this retreat package is £5555, a £1000 deposit is required ti secure your space, the rest can be spread over + up to 12 months, please let me know below how you would like to pay the remaining

Pay in full

12 months (£379.60p/m)

9 months (£506.12p/m)

6 months (£759.17p/m)

3 months (£1518.34p/m)

Other

Are you ready to devote the time, energy, finances + presence to this process?

Yes