Main Contact Name *

First Name

Last Name

Phone *

(###)

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Partner's Phone *

To be added to our Retreat GroupMe

(###)

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Is this a surprise for your partner? *

If you'd prefer that we don't contact your partner yet, please let us know! We do distribute information and details leading up to the event so please let us know when we are able to include them.

Yes, please keep this a secret for now!

No, my partner is aware

Have you attended Awaken Studios, Awaken Transformation or Awaken at Home? *

If not, please create an online profile in Momence before submitting this form, using the yellow button below the form so we can contact you to attach payment.

Yes, I have a Momence Profile

No, please contact me for help

Payment Preference *

Payment Options are to pay in full or to put down a $250 non-refundable deposit and have the balance paid over 4 months.

Pay discounted price of $1400 in Full

Payment Plan with $250 Deposit

Payment Approval *

If we are able to accommodate your request and you have a card on your Awaken profile, can we process payment BASED ON YOUR PAYMENT PREFERENCE LISTED ABOVE? This will secure your spot.

Yes, you can process payment

No, please contact me first (Spot will NOT be held until payment is received)

Cancellation Policy *

Are you aware of our cancellation policy and non-refundable $250?

Yes, I am aware that if I cancel I am subject to lose a minimum of $250 which is non-refundable