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Legal First & Last Name:
Business Name or Creative Alias:
Which are you?
Business/Brand IG Handle or Website
Home Zip Code:
Personal IG Handle -or- LinkedIn Profile
Were you referred by someone?
How do you plan to commute to the Catskills?
Is there a specific attendee(s) you wish to have as a room mate?
If you are selecting the 'Thriving Together' Package enter the following information for the person accompanying you.
What areas of your business or creative career do you find your self struggling in?
What areas of self-care do you find your self struggling in?
How did you hear about this retreat?
Why would you like to attend this Self-Care Retreat and what results do you wish to achieve?