Retreat REgistration Form Name * First Name Last Name Email * Phone * (###) ### #### What retreat(s) are you interested in? * To apply for a self-led winter retreat, please go to : https://mysticmountain.ca/self-led-winter-retreat-application-form Return To Nature (Personal Retreat) Return To Nature (Couples Retreat) Return To Nature (Group Retreat) 1 Day Silent Meditation Retreat (Specify Date) 1 Day Sound Alchemy Retreat (Specify Date) Dream Lodge Shamanic Winter Retreat Number of Guests, Date(s) of Retreat * What is your personal intention for your retreat? * Which healing services are you interested in experiencing during your RETURN TO NATURE retreat? See our Services Menu, and let us know if you would like to schedule additional sessions during your retreat. What specifically prompted or inspired you to do this for yourself, to invest in your wellbeing? What is your ideal day-to-day flow / routine (for RETURN TO NATURE retreat)? Will you be attending yoga, dance and or meditation? Are you willing to follow and honour our house and temple grounds rules during your stay? Please read and accept below. * Mystic Mountain Temple is situated on sacred grounds between 2 creeks in a pristine natural setting. When you enter the grounds you are in a sacred space. Please be calm, quiet, peaceful and respectful of the hosts, practitioners, other guests and members, and take a moment to be aware of the following general protocols that apply to the temple grounds. Absolutely NO Smoking, Drinking, Drugs INCLUDING Vape on the premises, No parties, glass bottles, loud music/yelling in order to respect others while they are in healing sessions, prayer or meditation. No Littering. Do not leave your food or garbage outside so as not to attract bears. Maximum 1 vehicle to park on premises in designated area. No pets allowed to protect the grounds, wild life, and resident animals. Please be kind to our animals and note that they are NOT ALLOWED INSIDE guest accommodations. Wifi use is limited, please plan accordingly. It feels so good to Live, Be, Rest and Rejuvenate in a fresh clean space. Please keep the cottage in a state that supports peace and clarity. Before you leave wash your dishes, wipe the counters and stove top. Leave things the way that you found them. Yes I agree to follow and honour the house and temple grounds during my stay. Thank you!