Application Form *

First Name

Last Name

Mobile Phone Number *

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Please check the following boxes to indicate you have reviewed and agreed to the Retreat Terms and Conditions (This is linked below if you need to reference it!) *

I understand that I must attend the minimum 10 hours of Reiki 1 & 2 Sat/Sun to receive certification and that all other activities are optional.

I will respect the retreat code of conduct.

I agree to the Refund policy: If I cancel before midnight Eastern October 15, I may receive a 50% refund minus a $75 transaction fee. After October 15, I will NOT be Refunded.