Peak Manifestation - Intake - The Peak Awakening

Intake Form - MANI Final(#19)

INTAKE FORM - Peak Manifestation: The Path To Epic, Soul-Aligned Results

Please take your time completing the questions below. They’re designed to help you clarify what you most want to create—and to help Kay understand your intentions, desires, and vision for this experience.

Your reflections will set the energetic foundation for your journey through Peak Manifestation: The Path to Epic, Soul-Aligned Results.

Be open, honest, and allow your truth to flow freely.

With appreciation,

Kay & The Peak Awakening Team

First Name

Last Name

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

Welcome to Your Peak Manifestation Journey

The questions below are intentionally designed to awaken curiosity, wonder, and intention as you step into Peak Manifestation: The Path to Epic, Soul-Aligned Results.

Allow your answers to flow freely—without judgment or overthinking. Trust the first words, images, or feelings that come through. They are your soul’s way of speaking.

You may be surprised by what emerges.

And know this: What you write here sets powerful energy in motion. Your participation in this program will become the living fulfillment of what you declare below.

What’s something that’s felt out of reach that you deeply want to bring to life by participating in Peak Alignment: The Path To Epic, Soul-Aligned Results? Where or what do you see you most want to change?

Why might you want to change (to have it be different than it currently is)?

How ready are you to change (to have it be different than it currently is)? Where ‘1’ means ‘Not Ready’ and ‘10’ means ‘Totally Ready.’

Why didn’t you pick a lower number?

Imagine you have changed, you've cleared your blockages and transcended your limits in this Experience, what would the positive outcomes be?

Why are those outcomes important to you?

What soul-aligned results or breakthroughs would make this program wildly successful for you? What do you want to feel more of in your life by the end of this program?

GETTING TO KNOW YOU QUESTIONS

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

What’s calling you to do this program right now?

When you’re facing a challenge, how do you typically respond or move through it?

This program is fast-paced, growth-focused, and soul-aligned. What makes you feel ready for that right now?

How do you see you will sabotage your success in this program? What will predictably take you out?

Is there anything else you’d like to share to help me support you during this program?

ATTENDANCE QUESTIONS

Please record your attendance as best as you know it right now. If your attendance changes, we will tell you what to do about it in the first session.

LIABILITY WAIVER & CONFIDENTIALITY AGREEMENT FORMS

After you submit this form, you will be redirected to a page where you can sign a Liability Waiver and Confidentiality Agreement. You are not considered approved for the program until these forms are signed.

Thank you.