Participation Screening for 2024 Healing with Nature Women's Retreat-PNW Therapy Adventur

First Name

Last Name

Address

Email

I am 18 year of age

Yes

No

I am cis-female

Yes

No

I am able to remain sober during the event without any physical or mental health concerns

Yes

No

I am physically and mentally capable of participating in Nature Based Therapy through body movement, self-reflection, breath work, energy work, journaling, sound bath healing, beginner hiking, and community gathering to improve my well-being

Yes

No

I am capable of sleeping in a tent outdoors without electricity, running water or sewage (bathrooms building are available with pit toilets)

Yes

No

Thank you for your interest in our 2024 Healing with Nature Women's Retreat. At this time, for every participants safety you must answer Yes to the above questions to considered for the retreat. If you did not answer yes but would like to know about our adventures please refer back to our Adventure Calendar.

Date

Your Signature

*