Registration Form

May 15–22, 2026 | Iceland

I’m so honored you’re ready to join this soul-deep experience. This form helps me confirm your spot and gather everything I need to welcome you into our small circle.

After you submit this form, I’ll review your responses and send you a PayPal invoice for your 20% non-refundable deposit within 48 hours. Your spot will be officially secured once your deposit is paid.

Only 4–6 participant spots available — this is an intentionally intimate retreat, led by me, for a total group size of 5 to 7 women.

Section 1: About You

First name

Last name

Billing Name for PayPal Invoice (Optional — if different from above)

Email (this is where your invoice will be sent)

Phone (Optional — for travel-day communication if needed)

Section 2: Travel Logistics

Do you have a valid passport that expires after November 2026?

Yes

Room Preference

Shared room ($3,500 per person — I’m open to rooming with another guest)

Private room ($4,000 per person — I prefer to have my own space)

Have you been to Iceland before?

Yes

If yes, when did you last visit?

Section 3: Your Intentions

Why do you feel called to join this retreat?

What are you hoping to get out of this experience?

Anything else you’d like me to know before we begin this journey together? (Optional — accessibility needs, emotional context, preferences, etc.)

Section 4: Wellness Info

Do you have any health conditions, injuries, or physical limitations I should be aware of?

Do you have any food allergies or dietary preferences?

Section 5: Payment Agreement

I understand that a 20% non-refundable deposit will be invoiced via PayPal within 48 hours of submitting this form to secure my spot. The deposit amount is:

$700 for a shared room
$800 for a private room

Yes, I understand and agree

I understand that the remaining balance is due by April 17, 2026.

Single choice

Yes, I understand and agree

Section 6: Final Details

How did you hear about this retreat? (Instagram, newsletter, friend, etc.)

Any final questions or thoughts before I reach out?