Women's Retreat Registration
Welcome! 💜We're so excited that you've chosen to invest in you. The Just Breathe Women's Retreat is an intimate weekend experience designed to help you pause, reconnect, and renew. From meaningful conversations and inspiring workshops to wellness activities, delicious meals and unforgettable moments of sisterhood, every detail has been thoughtfully curated with you in mind. Retreat Dates: November 20–22, 2026- Before you begin, please complete the registration form below in it's entirety. A $75 non- refundable deposit is required to reserve your spot. Once your registration is submitted, you'll receive a confirmation email along with your payment schedule and additional retreat information.
Full Name
*
First Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Relationship to Emergency Contact
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Retreat Information
Have you attended a Women With a Vision LLC event before?
*
Yes
No
How did you hear about this retreat?
*
Please Select
Facebook
Instagram
Friend/Family
Website
Email
Other
Room Style
*
Lakeside View
Resort View
Room Accommodations
*
Single (Additional $50)
Double
Triple (Additional $30 per person)
Quad (Additional $30 per person)
List Roommate Name/ Names & please submit a separate registration form for each person
Wellness Questions
Do you have any dietary restrictions?
*
Vegetarian
Vegan
Gluten-Free
Dairy-Free
Nut Allergy
Seafood Allergy
None
Do you have any medical conditions or physical limitations we should be aware of?
*
T-Shirt Information
T-Shirt Size
Please Select
XS
S
M
L
XL
2XL
3XL
4XL
Photo & Video Release
I understand that photos and videos may be taken during this retreat and may be used by Women With a Vision LLC for promotional purposes.
*
I Agree
Liability Waiver
I understand that I am voluntarily participating in this retreat and assume responsibility for my participation. I release Women With a Vision, its organizers, volunteers, instructors, and venue from liability for any injuries, illnesses, losses, or damages that may occur during the event.
*
I Agree
Transportation Agreement
I understand that transportation to and from the retreat is provided from New Castle County, Delaware only. I am responsible for arranging my travel to the designated departure location and arriving on time. I understand that no refunds or alternate transportation will be provided if I miss the scheduled departure.
*
I Understand
I certify that all information provided is accurate.
*
I Agree
Registration Fee
*
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Registration
$75.00
$
75.00
Quantity
1
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Credit Card
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