Women's Wellness Retreat
Registration Form

Please submit a separate form for each participant.

First name

Last name

Phone (for US numbers, please start with 1 then add your 10-digit phone number)

Country/Region

Address

City

Zip / Postal code

Birthday

Other contact info (website, Instagram, etc.)

Your retreat package

Please select your package (review packages here)

Retreat with Room A

1 person ($1,400)

2 people ($1,000 per person)

Retreat with Room C

2 people ($1,000 per person)

3 people ($1,000 per person)

4 people ($1,000 per person)

Retreat Pass (without lodging)

1 person ($900 per person)

Submitting your deposit

To complete your registration, please send a non-refundable deposit of $300 per person. (The remainder must be received by 7/1/25.) Payments can be made via check or Zelle. How will you be submitting your deposit payment?

I will mail a check to Cindy Conlon at N1545 Willowbrook Dr., Lake Geneva, WI 53147

I will send my payment to Cynthia Conlon (phone number 262-206-1329) through Zelle

Tell us about yourself

How would you describe your current state of well-being?

What would you hope to gain by attending?

What wellness practices/resources would you like to share?

Do you have any health issues that would prevent you from participating fully (past injuries, current physical limitations)? If so, please describe:

Do you have any allergies (to food, bees, etc.)? If so, please describe:

Do you wish to share a room? Please list the name of your roommate if you have one.

Anything else you would like to share?

Women's Wellness Retreat Registration Form

Your retreat package

Tell us about yourself

Women's Wellness Retreat
Registration Form