BECOMING UNCIVILIZED RETREAT LOGISTICS

NAME

First Name

Last Name

Birthday

MM

DD

YYYY

NUTRITION: Please 'identify' yourself.

Omnivore (I eat EVERYTHING)

Vegetarian (I do not eat meats but love veggies, I eat dairy, but no eggs)

Lacto - Ovotarian Vegetarian (I do not eat meats BUT I eat eggs and dairy)

Pescatarian (I eat fish but no other meats)

Vegan ( I do NOT eat any dairy nor eggs, obviously no meats)

ALLERGIES + MEDICATION: List any allergies and medication we need to be aware of. Allergies include FOOD ALLERGIES!

ARRIVAL TRAVEL: Date + Time + Flight Number

DEPARTURE TRAVEL: Date + Time + Flight Number

ENNEAGRAM: Would you like to take the Personality Test with Melayne Shayne?

YES

No, thank you.

QUESTIONS? Please add any questions you have regarding logistics.

We want to ensure that everyone feels supported during the experience. Part of this is understanding if any past experiences, including potentially traumatic ones, might affect how you engage with certain activities or content during the retreat. If there’s anything you think we should be aware of in order to provide the best care and support for you during the retreat, please share. Rest assured, anything you share will be kept confidential and handled with the utmost sensitivity and respect. Understand that we are not clinically trained therapists and if you require assistance of that nature this is not the container we create.