Soul EMpowerment Reset

Registration Form

First name

Last name

Phone

Emergency Contact Name

Emergency Contact Phone

Reset Details

Please note: Attendance on both days is required. Participants are expected to stay on the premises for the duration of the retreat—leaving early is not permitted.

Room Sharing

Please note that no single rooms are available. Attendees will be paired with another participant in each room. Additionally, male and female attendees will not be assigned to the same room. If you wish to share a room, you can specify a preferred roommate. If you prefer not to share, you will be partnered with another attendee of the same gender. If any couples are attending together, they can share one room.

Food Allergies & Dietary Restrictions

Please indicate any food allergies or dietary restrictions:

Our team will use this information to accommodate your needs.

Accessibility & Special Needs

Please specify any accessibility needs or accommodations required:

Additional Comments or Needs

I agree to participate in the retreat, attend both days, and stay on the premises for the duration.

I acknowledge that the organizers will do their best to accommodate my dietary, accessibility, and rooming needs.

Participation Policy

The organizers reserve the right to refuse or excuse any participant who, in their discretion, is not a good fit for the retreat or whose behavior is deemed inappropriate or disruptive. To ensure a positive experience for all, a brief conversation or screening will be scheduled prior to final approval of participation. Our goal is to maintain a safe, respectful, and enriching environment for everyone attending.