Retreat Registration – Mindfully Coached

If you purchased the Retreat with a Friend ticket option, provide the name and contact information for them as well as the emergency contact name and phone number for the second guest(s) attending the retreat with you. (For example: John Doe, abc123@mail.com (123) 456-7890). Type N/A if not applicable.

How did you here about the retreat?

What workshops or sessions interest you?

What do you hope to gain from attending this day retreat?

Would you be interested in presenting a session at the retreat? Sessions should be aligned with wellness in the mind, body, and spirit and can include: Meditations, sound baths, journal sessions, yoga, etc.

Yes No

Are you interested in purchasing a vendor table to sell your products and/or services at the retreat? *Note tables are limited and not guaranteed because of interest.

Yes No

Would you like to sponsor donated services or products? (Example: Sponsor photography, Sponsor in-kind Food, Snacks, or beverages, or samples of products and services)

Meals provided at the retreat do not serve or cater to any specific diet. By attending this retreat, you acknowledge and understand that the Organizer reserves the right to change menu food selections and that the menu is not directly serving any specific diet plans or diet preferences and may include foods that have dairy, nut, wheat, gluten, and other ingredients within them. Guests also understand that food preparation may be done in facilities where diary, nuts, wheat, gluten and other ingredients are used. You further understand that you are are required to disclose and let the Organizer, Retreat Host know by May 18, 2025 if you have specific food allergies or religious dietary preference.

I acknowledge and agree.

You acknowledge and agree that you are physically fit to voluntarily participate in certain physical activity, which may include but are not limited to, walking, swimming, hiking, biking, yoga, fitness activities, climbing, or other types of strenuous physical activities?

I acknowledge and agree.

Media Release: You acknowledge, agree, and understand that before and during the Retreat, you may be subject to photographs, video, sound recordings, or other media captures of your face, name, voice, or likeness and in consideration for your participation in the Retreat, you hereby and irrevocably consent to the use, publication, distribution, broadcasting, reproduction, live streaming, editing, recording, posting, copyrighting, licensing, digitization, and/or re release of the Released Media which may include but is not limited to, social media, commercial products, education, course materials, video footage, sales, marketing, or any other medium in any form that has been or will be invented. You further acknowledges and agree that any intellectual property submitted to Organizer is done at the Guest free will, and Guest hereby grants the Organizer an unlimited, irrevocable, royalty free, perpetual, fully paid up license to use such intellectual property in whatever way Organizer sees fit. Guest further warns that any such intellectual property is free from any license or incumbent and Guest agrees to indemnify the Organizer from any infringement thereon.

I acknowledge and agree.

Nurture and Navigate Day Retreat Registration

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