Reserve Your Elevated Alignment Retreat Spot - Con Smania Costa Rica

About You

Your Name(Required)

First Last

Phone(Required)

Email(Required)

Website

What is your main focus for this retreat?(Required)

Select all that apply

Conscious leadership development

Strategic visioning

Nervous system regulation & wellness

Deep healing & transformation

Preferred Retreat Date(Required)

Check all that apply

August 3-9, 2025

I would like to attend a retreat in September or October, dates to be announced shortly

I am open to attending either date

Will you be registering as a couple?(Required)

Just me

Yes, there are two of us sharing a bed

Yes, there are two of us sharing a private casita with two beds

Name of second registrant(Required)

First Last

Email address of second registrant(Required)

Upgrades

Would you like to add a Strategic Coaching Package with Nick and/or Jill?(Required)

Dive deep into the themes and opportunities that arise for you with the strategic brains of Jill and Nick. One additional private session during the retreat and Six 90 minute sessions to use within 3 months of the retreat.

Yes – +$2,000

No, but may decide to later

Would you like to add IV Infusion Therapy?(Required)

Optimal well-being, provided by our trusted doctors before or after ceremonies.

Yes – +$250

No, but may decide to later

Add extra nights at Con Smania CR?(Required)

More time for integration or exploration

Yes – +$240 per night per person

No, but may decide to later

Number of Nights(Required)

Used to calculate your total for the retreat. Payment for these nights at the time of your stay.

Please enter a number from 1 to 8.

Review & Estimate

Estimated Base Investment(Required)

Includes: Retreat, lodging for 6 nights, chef-prepared meals, smoothie bar, ground transport to and from Liberia, 90 minute massage and Complete Healing Session, pre- and post-retreat sessions

Estimated Total Add-Ons(Required)

Based on your choices, subject to change during discussion

Estimated Total Investment(Required)

Base + Add-ons = Your Estimated Total

What else do you want to share with us to prepare for our conversation?(Required)

We will send a Medical and Health questionnaire to be completed before your initial consult. This is important to ensure your safety and well-being and make sure this is feasible for you. Please refer to the Safety Guidelines on the event page FAQ section. Here, you can give us deeper information or ask initial questions that are on your mind.

We'd love to know how you heard about us

Facebook post or group

I know one of the Collective members

Internet search

Local connection

Who can we thank for the referral?

Next Steps

How would you like to pay the $3000 deposit?(Required)

Based on your selection, you will receive a link or payment instructions.

Credit card

Zelle

Paypal

Wire Transfer

After clicking on Register below, you will be redirected to use your credit card to pay the deposit via Stripe. Once completed, you will be at our scheduling page so you can get your intitial consult on Jill's calendar.

After clicking on Register below, you will be shown our Zelle and Wire Transfer information and to schedule your Initial Consultation with Jill. This will also be sent via email.

After clicking on Register below, you will be redirected to pay at PayPal. This will also be sent via email along with the link to schedule your initial consultation call with Jill.

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Reserve Your Elevated Retreat Spot

About You

Upgrades

Review & Estimate

Next Steps