Frequency Of Healing – Application Form

Section 1: Your Information

Your First name

Your Last Name

Your eMail

Your Phone Number (if we need to contact you by phone)

Section 3: Alignment & Expectations

What would make this retreat a life-changing experience for you?

Have you participated in other healing retreats, workshops, or therapies before?

Yes, often

Occasionally

This would be my first

This retreat is not for everyone - it requires courage, openness, and willingness to face deep truths. Why do you feel you are a good fit for this experience?

Are you prepared to unplug from daily distractions (phone, work, outside obligations) and be fully present during the retreat?

Yes

Possibly, with some adjustments

Section 4: Practical Considerations

Do you have any health, mobility, or dietary needs we should be aware of to best support you?

Do you understand that attendance is limited to 20 people, and your spot will be confirmed only upon acceptance?

Yes, I understand and agree

Are you financially prepared to commit to the retreat investment if selected?

Yes

Is there anything else you’d like Anita and Erika to know about you as they review your application?

If you are human, leave this field blank.

12th - 14th DECEMBER 2025

Section 1: Your Information

Section 2: Personal Readiness

Section 3: Alignment & Expectations

Section 4: Practical Considerations