Application Form

Which retreat are you applying for? *

Winter 2024

6th - 11th May 2025

Name *

First Name

Last Name

Preferred Name *

First Name

Last Name

Pronouns *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

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###

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 Please read and accept the following Terms & Conditions and our Ground Rules. These are a requirement for anyone attending Frequency of Love. Please not that our process includes a review of this application and an interview via video call. Please complete this application form to the best of your ability and that you are ready to join us at Frequency of Love. Following your interview you will be required to complete a medical information form and a declaration and consent agreement to be signed before participation in Frequency of Love Retreat. *

I confirm that I have read and agree to the Terms & Conditions

I confirm that all the information provided in this application is accurate and complete to the best of my knowledge. I understand that the retreat facilitators will use this information to determine my eligibility for the Frequency of Love Retreat.