Step 1 of 3
About YOU Street address
City
State
ZIP code
Gender Please Select Female Male We only ask this question for rooming assignment purposes.
What is your current employment status?
What is your current position?
Do you have children and/or stepchildren? Select one Yes No
If yes, tell us about them — how many, and their ages
How did you hear about Unlocking YOU?
What is your primary reason for a retreat? (connection, healing, rest, quiet, rejuvenation, growth, self-care, solitude, clarity, fresh perspective, encouragement, next steps, reflection, space to listen, reset, enjoy the outdoors, dream again, find hope, laughter, etc.)
Please list your goals for attending this retreat
Year(s) you were diagnosed?
What was your diagnosis?
Anything about where you are in your journey you'd like us to know?
Step 2 of 3
Caring for YOU well
Dietary needs
Please list any other food allergies/restrictions and/or provide additional information you'd like us to know about items you marked above
Faith
What is your faith or religion?
Will you have specific spiritual/religious needs or observances during this retreat (i.e. observe the Sabbath)?
Mental, Behavioral, and Relational Health History
Please list your sources for emotional support
When emotionally activated, flooded or upset, what do you do to ground or become settled again? Or perhaps you're in need of some tools?
Please describe any traumas or events, not limited to cancer, that have had a significant impact on your life you feel comfortable sharing (optional)
If 'in the last 2 weeks' applies to any of the above, please describe
Legal History
Please explain your charge(s) or conviction(s)
Please describe any current or past legal involvement
Do you anticipate any ongoing legal issues will interfere with this retreat? (i.e. requiring letters, phone calls, pre-occupation)
Transportation & carpooling
Transportation is the responsibility of each participant. Carpooling may be possible with others flying in or driving from your area.
(Just prior to the retreat, we will share names and phone numbers of individuals looking to carpool — either from the airport or your area — so you can finalize arrangements together.)
Emergency contact
Emergency Contact Name
Emergency Contact Phone Number
photo-consent I give UnlockingYOU permission to use photos or video taken of me during the retreat in future materials. Participation in photos is always voluntary.
Step 3 of 3
Where you'll stay *Take note of the room you like, you'll select it when completing payment on the next screen.
Birdie Rose & Maverick
$550
Twin beds, shared baths
Ballena Lodge — King
$650
Private Room — private bedroom, shared baths
Ballena Lodge — 2 Beds
$650
Private room for two — two beds, shared bath
Wynne Cabin
$750
Private Room — private bedroom & bath
Kendall Cabin
$850
Private Suite — two queen beds, sitting area, porch & mountain views
🔒 Clicking submit saves your registration and takes you to our secure Zeffy checkout, where you'll choose your room and pay.
⚠️ Important heads up: Zeffy is a payment platform for nonprofits. You will notice at checkout, on page 2, that Zeffy automatically adds an optional gift to Zeffy as a way of covering all transaction processing fees for all nonprofits that use Zeffy. It is listed as an 11% additional charge under “Help keep Zeffy free”, which is not part of Unlocking YOU’s registration costs. Should you choose to bless Unlocking YOU and other nonprofits by covering transaction fees, you can keep the 11% as is. To opt out, simply click the drop down → select other → and type in $0.00 for contribution. Again, it’s absolutely optional and not required! If you opt out, don’t worry, Unlocking YOU will still receive 100% of the transaction because of others who’ve paid the % across the platform and their overflow has graciously extended to us.
📝 Payments are non-refundable in the case of cancellation, but can be transferred to a different retreat. By typing your full name you acknowledge our registration terms and liability waiver.
