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Wild Roots Retreat Application

Wild Roots Retreat Application
Greetings Sacred Sister!
Participation in the Wild Roots Retreat programs requires completion of this application.
Once you have been pre-approved, you will receive a ‘Welcome Packet’ and invitation to join one of our immersive retreat experiences!
If you are approved, you may join ANY program - one or many. However, we need your application to be fully processed. We are excited for you to join us!
Please add rebecca@kambospiritpath.com to your contacts to ensure you receive the second set of instructions. Emails can sometimes go to "promotions" or "spam" folders.
All answers are secure and private. For your safety, it is essential to be 100% transparent and clear with your application. All information is kept confidential.
This form will take 5-7 minutes to complete.
First Name
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Last Name
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Email
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Where are you located? (City, State)
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How did you hear about Wild Roots Retreat?
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What is your interest in attending a Women’s Rewilding Retreat experience?
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Have you ever attended a rewilding retreat or women’s circle before? And if so, what was your experience like? Please explain.
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Are there any practices or ways that you currently connect to the Wild Woman archetype? Would you describe yourself as a Wild Woman? Are you not sure, but interested in exploring your connection with this archetype more? Please explain.
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Receiving Kambo and other sacred medicines in a safe & health screened ceremonial container is a part of this retreat experience. Have you ever received Kambo before? (Please include how many times and more details about your experiences working with Kambo…)
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Have you ever experienced working with psychedelics or entheogens? (If so, which ones, how often and when?)
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What is your interest/intention in working with Kambo and/or other sacred medicines at this time?
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What are some of the areas in your life that you feel blocked in or would like to improve? (For example: career, wellness, health issues, motivation, clarity, etc. - Please explain).
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Do you have any current health challenges or existing medical conditions? (If so, please be 100% transparent, clear, & precise with your information.)
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Have you ever experienced health challenges in the past? (If so, please be 100% transparent, clear, & precise with your information.)
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Have you ever experienced depression or anxiety? (If so, please be 100% transparent, clear, & precise with your information.)
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What is your current support system (friends, family, etc) and how do they inspire your growth?
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What is your BIG DREAM or sacred intention for the next year, and what do you hope to gain from this experience as a whole?
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What moments in your life have you felt the most inspired and alive?
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What is your relationship like with the women in your life (friends, mother, sisters, family, peers, colleagues, etc…)?
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Do you feel safe, supported, and seen by the women in your life? Do you desire to be surrounded by a community of women that can further support you at this time? Please explain.
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What is your relationship like with the natural world? Do you have a regular practice of connecting with nature? Do you have any fears of the outdoors or nature? Please explain.
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What does your daily self care and/or spiritual practice look like? Are you wanting to make any changes, or is it currently working for you? Please explain.
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What is your medicine, gift or purpose to share with the world (if you’ve identified it)?
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Is there anything else you’d like to tell us about yourself? Or any additional thoughts or questions you’d like to include in your application?
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