Request a Place

Application for the gathering

Twenty-two places at the fire. Take your time with these questions — your words are how we come to know you.

Personal Information

Full legal name *

Preferred name

Phone number *

Email address *

Age *

City, state, and country *

Profession or current area of work

What are your hobbies, passions, or favorite ways to spend your time?

Emergency contact — name, relationship, and phone number *

Dietary Preferences

Which option best describes your current diet? *

Do you have any food allergies, sensitivities, or dietary requirements? Please explain.

III

Your Intentions

What inspired you to apply for this retreat?

How do you envision the highest and most fulfilled version of yourself?

What is one habit, behavior, or area of your physical well-being that you genuinely desire to transform?

Is there an emotional, spiritual, personal, or professional area of your life that you feel ready to strengthen or release?

What would make this retreat feel truly meaningful and successful for you?

What intentions would you like to bring into this experience?

Are you open to participating in group activities, guided practices, movement, reflection, and community discussions? *

Health and Support

Are there any health conditions, injuries, mobility needs, allergies, medications, or personal circumstances our team should know about to support you safely?

Are there any activities or practices you may need modified during the retreat?

Is there anything that helps you feel especially safe, comfortable, respected, and supported in a group environment?

Final Reflection

Why do you feel this is the right time for you to attend this retreat?

What qualities, energy, or gifts do you hope to contribute to the retreat community?

Is there anything else you would like our team to know about you?

Participant Commitment

By submitting this application, I understand that a retreat is a shared experience. I agree to arrive with openness, personal responsibility, respect for others, and a sincere willingness to participate in my own growth and transformation.

I understand and agree.