Questionnaire

Brilliant! We need just a bit more info from you to get you booked in. Please take 5-10 minutes to fill out the Questionnaire below.

In which context of your life are you most keen to see change right now?*
- business - build systems & processes including customer attraction & retention
- leadership - courage to stand up & speak out, vocalise your values
- money - increase your income & wealth or create more resources in general
- romance - deepen your connection with a partner or attract a soulful relationship
- parenting - be calm, kind, and encouraging with your children
- health - cultivate physical, mental, & emotional wellbeing & fitness
- self-awareness - positive body image, self-confidence, self-compassion
In that context, what do you want?*
Why is that important?*
How do you know when you have done well in that context?*
What is your current experience of that context?*
In that context, what is the relationship between what's current now and what you experienced 12 months ago?*
What has changed recently for you to want to invest in changing this context now?*
What's the best help anyone can be for you now in relation to achieving your goals?*

Couples Retreat

What's your first name?*
What's your last name?*
Email*
How can we call you?
Payment Process*
- Full Payment
- Payment Plan
Full Payment
Price:
Payment Plan

3 Months to Pay (Monthly Payment of AUD$550) Payment Date: March 15, April 15, May 15
Total
$ 0.00
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Do you agree to the Terms & Conditions**
- Don't Agree
- Agree
Download Terms and Conditions here
Do you agree to the Indemnification Form*
- Don't Agree
- Agree
Download Indemnification Form here