Retreat Application — Badass Retreats

Name

First Name

Last Name

Email Address

Emergency Contact

First Name

Last Name

Emergency Contact Phone

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Are you currently taking any prescription medications?

How would you rate your current physical health?

How would you rate your current mental health

What do you consider to be some of your badass strengths?

What do you consider to be some of your biggest challenges in being a badass?

What area(s) in your life would you like to improve most?

What would you like to accomplish at Badass Retreats?

In what ways will this impact your life in a positive way?

Have you ever done a juice cleanse, fast or health detox?

How many times per week do you generally exercise?

What type of diet do you eat?

Please list any difficulties you experience with your appetite or eating patterns?

What is your favorite way to sweat?

What type of exercise’s are you most interested in?

What significant life changes or stressful events have you experienced recently?

Tell me a quote do you live by?

What do you want to be remembered for?

What is the theme song of your life?

What else do you want us to know about yourself?