Awaken Your Soul Power Retreat - Application Form

1TREATI Text (transparent)(3.75 x 2.5 in)

TREATI Application Form (#15)

APPLICATION FORM - The Awaken Your Soul Power Retreat

Please take your time filling out the questions below. They are intended to support you in getting clear on what you want to accomplish in this Retreat and to let us decipher if what you want to accomplish is a match for the retreat programming. If this retreat is not a match, we will let you know prior to requesting your tuition. So, please be as authentic as possible so we can be sure this program is a match for what you want and need.

Prior to the program, we will be sending you an intake form to further deepen what you write in this application.

Thank you.

> Kay & The Peak Awakening Team

First Name

Last Name

Email

Phone/Mobile

Facebook Name/Handle (Note: Please also add ‘Kay Z Zakrzewski as a friend if you’re not already friends on Facebook)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Birth Day

FULFILLMENT QUESTIONS

What is the biggest thing you wish to accomplish out of participating in the Awaken Your Soul Power Retreat?

Why are those outcomes important to you?

GETTING TO KNOW YOU QUESTIONS

What are you currently doing to support your mental, emotional, or spiritual well-being?

What’s calling you to be reclaim your soul power right now?

Does any of this resonate with you: You are a high achieving leader who’s built success but feels a longing for something more — and you’re ready to create Peak Prosperity™ by living your soul’s purpose — to release obligations, reset your energy, and return home clear, soul-aligned, and lit up on the path to Peak Prosperity™? If yes, please elaborate.

RETREAT-SPECIFIC QUESTIONS

Please indicate which accommodation type you are selecting below:

ACCOMMODATION A: Luxury Primary Suite with Ensuite Bathroom

Furnished with loose weave fabrics of natural colors this exquisite space features a king bed, en-suite with elegant stone tub, a large terrace, and a breathtaking ocean view.

> DOUBLE Occupancy
>1 king bed
> Spacious ensuite bathroom with soaker tub

Super Early Bird Pricing: $5,197 USD per person

[Regular Pricing: $5,997 USD pp]

ACCOMMODATION B: Single Room with Ensuite Bathroom

The gentle chorus of the jungle surrounds these glamping tents, filling their inviting space with a calming, cheerful energy. These single suites are the most private option.

SINGLE Occupancy
> One double bed
> Ensuite bathroom
> Glamping tents

Super Early Bird Pricing: $4,697 USD per person

[Regular Pricing: $5,497 USD pp]

ACCOMMODATION C: Double Room with Ensuite Bathroom

These suites truly embrace their gorgeous settings allowing a great connection to the harmonious natural environment, where one can fall asleep to a toucan serenade.

> DOUBLE Occupancy
> Two double beds
> Ensuite bathroom
> 1 suite in the main house + glamping tents

Super Early Bird Pricing: $4,497 USD per person

[Regular Pricing: $5,247 USD pp]

ACCOMMODATION D: Double Room with Shared Bathroom

The Mariposa glamping tent experience allow you to step away from the excess of modern life, stimulating the sense and the imagination. The shared private bathroom facilities are a short walk away.

> DOUBLE Occupancy
> Two double beds
> Shared private bathrooms
> Glamping Tents

Super Early Bird Pricing:
$3,997 USD per person

[Regular Pricing: $4,797 USD pp]

Please indicate which room you are selecting

ACCOMMODATION A: Luxury Primary Suite with Ensuite Bathroom

ACCOMMODATION B: Single Room with Ensuite Bathroom

ACCOMMODATION C: Double Room with Ensuite Bathroom

ACCOMMODATION D: Double Room with Shared Bathroom

Note: Your initial deposit of $1750 USD is due immediately upon acceptance into the retreat to reserve your room. Your remaining deposit is due November 1, 2025. If you need a customized payment plan, speak with the travel agent who reaches out to complete your registration.

Are you requesting a specific roommate for this retreat? If so, please indicate who below (first and last name).

I have read and agree to the Terms and Conditions, Privacy Policy and Cancellation Policy.

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