2019 Life Vision Retreat Application

New Year's Life Vision Retreat

What is the highest vision for my life?

Thank you so much for applying to participate in the Life Vision retreat in San Diego with Dawson!

Please fill out the information below. The purpose of this information is to provide us with background information in order to create the most positive possible experience during the retreat. Your medical and personal information is confidential.

ENTER YOUR CONTACT INFORMATION

Divider Text

First Name

Last Name

Phone

Emergency contact (name, relationship, phone number)

Age

Please describe your deepest reason for wanting to go on this retreat.

If you plan on sharing a room, do you have someone? (please put any other room requests here)

What would you most like to offer the group? It could be morning yoga classes, a music or dance performance, massage, essential oils, energy treatments, music, a mentoring experience, or any other gift you feel called to give.

Please list any medical conditions with which you have currently been diagnosed.

Please list any medications that you are currently taking.

If so, please list:

Divider Text

AGREEMENT

To the best of my knowledge, I have listed all of my past and current conditions.

By submitting this form, I agree to the Disclaimer, Terms of Service, and Copyright Agreement of Energy Psychology Group, Inc.
https://www.eftuniverse.com/faqs/terms-of-use-and-privacy-policy

https://www.eftuniverse.com/eft-in-business/disclaimer

ACCEPT: By clicking you agree that you are signing this Agreement electronically

SUBMIT

We look forward to spending this time with you!

See you at the retreat!

Dawson and Christine