Healing Through Divorce Retreat | Somatic Wendy Elliott

Befriending Time Retreat – Registration

Registration – Befriending Time Retreat 2025

First Name *

Last Name *

Email *

Cell Phone *

Home Phone (if applicable)

Address

Street address

Address

City

State/Province

Zip/Postal

If you came to this retreat and left thinking I’m SO glad I did that! what would have happened?

Are you currently seeing a therapist, psychologist or psychiatrist? If so, what are you in treatment for?

Do any of these apply to you?

I have an active addiction

I have a history of trauma

I have anxiety and/or depression

Do you have any food allergies? If yes please explain:

For the food allergies list above, please describe your allergic reaction:

Do you have any dietary restrictions? If yes please explain.

Do you have any food preferences, sensitivities or anything else we should know in terms of your diet. If yes please explain.

How did you hear about our retreat?

Additional Comments/Questions About our Retreat:

Select a Room, the 50% deposits need to be the following:

Master 1 – King $2100 (50% deposit $1050)

Master 1 – Single $1900 (50% deposit $850)

Master 2 – Twin $2000 (50% deposit $1000)

Bedroom 3 – Single $2000 (50% deposit $1000)

Bedroom 4 – Queen $2,000 (50% deposit $1000)

Sunroom – $2,000 (50% deposit $1000)

Total

If you are human, leave this field blank.

CONTACT WENDY
info@somaticwendyelliott.com
(805) 640-0579
Ojai, California