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 Grounding Monday 10:20-11:30am MOVEMENT The whole body Monday 5-6pm ENERGY TOOL Your space Monday 6:30-7:30pm EVENT Aura Healings Tuesday 9-10 am MEDITATION Running earth and cosmic energy Tuesday 10:20-11:30am MOVEMENT Legs and Feet Tuesday 5-6pm ENERGY TOOL Female energy Tuesday 6:30-7:30pm EVENT Group reading Wednesday 9-10 am MEDITATION Creating and Releasing Wednesday 10:20-11:30am MOVEMENT Spine Wednesday 5-8pm EVENT Outdoor Sauna Thursday 9-10 am MEDITATION Protection Thursday 10:20-11:30am MOVEMENT Pelvis Thursday 5-6pm ENERGY TOOL Creativity Thursday 6:30-7:30pm EVENT Fire circle Friday 9-10 am MEDITATION Own the center of your head Friday 10:20-11:30am MOVEMENT Belly Friday 5-6pm ENERGY TOOL Forgiveness Friday 6:30-7:30pm EVENT Mary Magdelene Healings Saturday 9-10 am MEDITATION Goals Saturday 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?
 Monday Tuesday Wednesday Thursday Friday

Overnight Accommodations:
 Yes I snore and or talk in my sleep No I do not snore or talk in my sleep

Food will be prepared in a shared space. Do you have allergies?*
 Gluten Nuts Dairy Seafood Is 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, $70 30 minute massage, $45 60 minute reading, $120 60 minute massage, $85 I 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 events I 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.