Cape Cod Women’s Retreat Signup Form

First Name:*

Last Name:*

Your Email:*

Phone:*

Street Address:*

City:*

State:*

Zip Code:*

Write a brief statement on why you would love to attend this retreat and what you would like to create for yourself in this sanctuary:
example: I hope to...

Previous Psychic, Energy Awareness and Meditation Training?*
No experience necessary.

Schedule Description:*
Please check the workshops and events you are attending. You will need to call CFPH when you want to add or adjust your schedule.

Monday 9-10 am MEDITATION GroundingMonday 10:20-11:30am MOVEMENT The whole bodyMonday 5-6pm ENERGY TOOL Your spaceMonday 6:30-7:30pm EVENT Aura HealingsTuesday 9-10 am MEDITATION Running earth and cosmic energyTuesday 10:20-11:30am MOVEMENT Legs and FeetTuesday 5-6pm ENERGY TOOL Female energyTuesday 6:30-7:30pm EVENT Group readingWednesday 9-10 am MEDITATION Creating and ReleasingWednesday 10:20-11:30am MOVEMENT SpineWednesday 5-8pm EVENT Outdoor SaunaThursday 9-10 am MEDITATION ProtectionThursday 10:20-11:30am MOVEMENT PelvisThursday 5-6pm ENERGY TOOL CreativityThursday 6:30-7:30pm EVENT Fire circleFriday 9-10 am MEDITATION Own the center of your headFriday 10:20-11:30am MOVEMENT BellyFriday 5-6pm ENERGY TOOL ForgivenessFriday 6:30-7:30pm EVENT Mary Magdelene HealingsSaturday 9-10 am MEDITATION GoalsSaturday 10:20-11:30am MOVEMENT/CLOSING CIRCLE: Putting it all together

List any special accommodations or assistance you need in order to participate in this retreat:

Your Retreat Week:*
Yes, I would like to stay in the Bungalow with a queen bed for a $275 fee per stay (not night)No, I do not need housing. I live locally and will drop in for the week, a fee of $100.I would like a campsite for a fee of $175 per stay (not night)

Which nights would you like to stay?
MondayTuesdayWednesdayThursdayFriday

Overnight Accommodations:
Yes I snore and or talk in my sleepNo I do not snore or talk in my sleep

Food will be prepared in a shared space. Do you have allergies?*
GlutenNutsDairySeafoodIs this life threatening?I do not have allergies

Private sessions are available mid-day during your retreat. Would you like to set a private session for yourself during the retreat?
Please see website for more information on services: www.centerforpsychichealing.com and www.massageonmainstreet.com

30 minute reading, $7030 minute massage, $4560 minute reading, $12060 minute massage, $85I may. I will decide during the retreat.

Center for Psychic Healing:*
Are you interested in learning more about the trainings and healings at the Center?

Yes, I am interested in the Inner Light Program, a 1 year intensive.No, I want to attend the retreat, but I am not interested future eventsI would be interested in hearing more. Please put me on your mailing list for upcoming events.I have a friend who would love to hear about the Center.I would like to receive a reading or healing in the future. Let's make an appointment.