Full Name *

Phone *

Email *

Gender:

Website OR Social Media

Address

Street Address *

City

State

Country

Postal code

YOUR WHY & INTENTIONS:

What draws you to this facilitator training program? Why do you feel called to step into facilitation? *

What kind of circles, workshops, or spaces do you envision holding in the future? *

What is your biggest hope for this training? What do you wish to walk away with? *

YOUR EXPERIENCE & READINESS:

Do you have any previous experience holding space for groups? *

If you have facilitation experience, please describe it. *

Do you have experience with healing modalities, or guiding others in any way? (Check all that apply) *

Therapy, coaching or mentoring.

Reiki or other energy healing.

Meditation or guided journeys.

Yoga, Pilates, Dance, or any movement practice.

RMT or any massage modality

None, but I’m open to learning.

Other

How comfortable are you speaking in front of a group? *

What strengths do you bring to facilitation? *

What are your biggest fears or hesitations about stepping into facilitation? *

COMMITMENT & ALIGNMENT

This is a 5 day - 4 night immersive experience requiring participation, engagement, and practice. Are you fully committed to showing up for yourself and the group? (Check one.) *

Yes, I am fully committed.

I want to, but I have some constraints.

I’m unsure at this time.

Are you open to receiving feedback and practicing facilitation in a supportive space? (Check one.) *

Yes, I welcome constructive feedback.

I feel nervous but willing to try.

No, I prefer to observe rather than practice.

LOGISTICS AND PAYMENT

We offer flexible payment options. How do you plan to pay? (Check one.) *

One-Time Payment

Payment Plan

I need financial assistance and would like to discuss options.

Do you have any questions or concerns about the program before committing?

FINAL ACKNOWLEDGEMENT

By submitting this application, I acknowledge that:

I am ready to show up for this experience with an open heart and mind.
I understand that this training is not just informational but also transformational.
I am willing to participate, engage, and honor the sacredness of this journey.
I will be part of promotional content

Signature

Clear

Date

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to {{location.phone}} for assistance. You can reply STOP to unsubscribe at any time.