Healing Through Divorce Retreat | Somatic Wendy Elliott

Healing Through Divorce Retreat – Registration

Registration – Healing Through Divorce 2025

First Name *

Last Name *

Email *

Cell Phone *

Home Phone (if applicable)

Address

Street address

Address

City

State/Province

Zip/Postal

Have you have filed for dissolution or legal separation?

Yes (If yes, please state what county did you file in)Yes (If yes, please state what county did you file in)

If you have filed for dissolution, have you filed to dissolve your marriage, your partnership, or both?

Neither

Marriage

Partnership

Both (marriage & partnership)

Do you currently have an attorney?

Yes

Do you have children?

Yes, (if yes, please state their ages)Yes, (if yes, please state their ages)

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

Master 1 – King $2600 (50% deposit $1300)

Master 1 – Single $2200 (50% deposit $1100)

Master 2 – Twin $2200 (50% deposit $1100)

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

Bedroom 4 – Queen $2200 (50% deposit $1100)

Sunroom – Queen couch-bed $2100 (50% deposit $1050)

Total

If you are human, leave this field blank.

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