Heal The Healers Retreat Application Step 1 of 4 25% Contact DetailsName(Required) First Last Email(Required) Enter Email Confirm Email Phone Tell Us....What first interested you about this retreat?(Required)What are you most excited about experiencing on this retreat?(Required) Plant Medicine Time with other Healers Personal growth work Going to Costa Rica What is your most memorable interaction that solidified your commitment as a Healer?(Required)Have you had previous psychedelic experiences? Were they recreational or ceremonial? What do you want to share about them?(Required) Some logisitics....Gender(Required)MaleFemaleNon-binaryAgenderMy gender isn't listedPrefer Not to AnswerAge(Required)16-2425-3435-4445-5455-6465+How did you hear about this retreat?(Required) PaymentAre you able to cover the $5555 fee for registration?(Required) Yes, no problem Yes, but would like a chance at some assistance Not right now, but think I'm a great candidate for the future This is just our first offering of the Heal The Healers Retreat, tell us....(Required) I definitely want to be considered for this February 2025 event I probably can make this one, but would like to be considered for future offerings as well I can't make these dates, but would like to be considered for future offerings I'm interested in helping contribute to future offerings Are you prepared for the time committment for this kind of gathering?(Required) I am available for preparation work in advance of the retreat I make my own decisions as far as my schedule I know that integration after the retreat is important and worth my time PhoneThis field is for validation purposes and should be left unchanged.
