Authentic Relating in the Wild Intake Form

I am so glad you are here! Please fill out this intake form to reserve your place on the Authentic Relating Level 1 and 2 combined program.

Name

First Name

Last Name

Date of Birth

YYYY

Address:

How did you hear about this Immersion?

Why do you want to join the combined L1/L2 Authentic Relating Immersion?

This is a nature-based retreat. Are you comfortable spending long hours outdoors?

Are you comfortable walking on trails for up to 1 mile/ 2 kilometers? Some of our session locations are walk-in only. (There will be plenty of opportunity for longer hikes).

Mammoth Lakes, CA is at 8,000 feet or 2,400 meters. Are you aware of the effects of altitude and how to support yourself in acclimatizing? (We are here to help!)

Accommodation is not included but we are happy to help you find something suitable. Are you interested in sharing with other participants? If so, what are you looking for (campsite, airbnb, resort, etc)?

Is there anything else that you would like to share?