Retreat Application Form:

Legacy Codes Waitlist

Thank you for your interest in our retreat. It's an absolute honour to explore the possibility of having you join us!

If this resonates with you, I invite you to complete the information below. Once received, your enquiry we will contact you with more information about the upcoming retreat.

With gratitude and reverence

Maryanne

Please note: Your responses to the questions in this application are strictly confidential and will not be shared with anyone other than my business partner, Lisa Kasiaras.

Name

First Name

Last Name

Mobile Phone

Country

(###)

###

####

Business Name

Website

http://

Industry

Number of Employees

What similar retreats or workshops have you done?

Do you have a regular spiritual practice such as meditation, prayer, breathwork, icebaths, yoga, etc.? If yes, please describe.

What draws you to this intimate and immersive retreat experience? Explain in as much detail as possible.

What are the three things in your life you’d most like to shift and the intention and commitment you have for yourself by stepping into this retreat container?

What would need to happen for you to feel that this program was a success for you?

The practices, training, and exercises in this program can be physically and emotionally demanding. Do you have any medical conditions that might restrict your full participation in this program? If yes, please explain.

Have you in the past two years been under the care of a therapist or mental health professional? Have you ever experienced any traumatic or emotional conditions that could be relevant to this program, including childhood emotional or physical abuse? If yes, please share those circumstances in detail, when they began and their duration, including whether or not you received or are currently receiving treatment.

Is there anything else you would like us to know?

You agree to sign a confidentiality agreement prior to the retreat

Yes

And lastly, a deep-dive of this highly focused and personal program means that results will vary for each individual. No two expereinces are the same. Please read the statement below and click the button if you agree: "I am ready and willing to dive deeper into myself, to be curious about this journey and take responsibility for this transformation."

Yes

Retreat Application Form:

Legacy Codes Waitlist

Transforming All Aspects Of Your Business For The Greater Good Of All.