Register for Peaceful Power Retreat

Peaceful Power Retreat

Retreat Registration

Complete the form below to choose your retreat package, review the total payment amount, and reserve your spot for the Peaceful Power Retreat. Payment is required at registration.

Mt. Pleasant, Utah • June 25–27, 2026

After your registration is complete, Dorothy will follow up with lodging, parking, packing, and arrival details as the retreat gets closer.

Room and bed packages are limited and may change as spots are reserved. The form below shows current availability and the payment amount before checkout.

Peaceful Power Retreat Registration

How would you like to pay?

Pay $100 deposit today

Pay in full today

Choose your retreat package — $100 deposit

Private Queen Room — $100 deposit today, $425 due by June 10

Shared Queen Room — $100 deposit today, $295 due by June 10

Bunk Bed — $100 deposit today, $245 due by June 10 — Only 3 left

Bring Your Own Gear — $100 deposit today, $175 due by June 10

Choose your retreat package — pay in full

Private Queen Room — $525

Shared Queen Room — $375

Bunk Bed — $345 — Only 3 left

Bring Your Own Gear — $275

Private Queen Room Inventory Hold

Second Queen Room Spot

Participant Details

Please enter the participant’s contact details.

First Name

Last Name

Preferred Name

Phone

T-Shirt Size

Women’s Small

Women’s Medium

Women’s Large

Women’s X-Large

Women’s XX-Large

Emergency Contact

Please provide someone Dorothy can contact in case of an emergency.

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Other Relationship

Retreat Needs & Notes

Please answer these questions so Dorothy can prepare appropriately for your stay and support participant safety.

Food Allergies / Dietary Restrictions

No known food allergies or dietary restrictions

Food allergy — please describe severity

Vegetarian

Vegan

Gluten-free

Dairy-free

Other

Food Allergy Details

Other Dietary Need or Restriction

Do you have any health, mobility, or participation considerations Dorothy should know about?

No — I do not have anything to share

Yes — I have something Dorothy should know

Health, Mobility, or Participation Considerations

Is there any medical information you would want emergency responders or the retreat host to know in an emergency?

No — I do not have anything to share

Yes — I have emergency medical information to share

Emergency Medical Information

Roommate Request

Questions or Notes for Dorothy

Agreements, Policies & Payment

Review the agreement, confirm your package total, and complete payment to reserve your spot.

Activity Participation Agreement

I understand that retreat activities may include movement, yoga, meditation, breathwork, workshops, coaching, outdoor activities, and optional self-defense training. I understand that participation is voluntary and that I may modify, pause, or stop any activity at any time.

Health & Personal Responsibility Agreement

I agree to listen to my body, communicate any important limitations or concerns, and take responsibility for choosing what activities are appropriate for me. I understand that Dorothy and retreat instructors are not providing medical care or medical advice.

Assumption of Risk & Liability Waiver

I understand that participation in retreat activities involves inherent risks, including but not limited to physical injury, emotional discomfort, illness, accidents, travel risks, weather, and acts of nature. I voluntarily assume responsibility for these risks and agree to release and hold harmless the retreat host, instructors, venue, and affiliates from claims or liability related to my participation, except where prohibited by law.

Emergency Medical Authorization

If emergency medical care is needed and I am unable to consent, I authorize the retreat host or designated staff to seek emergency medical assistance on my behalf. I understand that I am responsible for any medical costs incurred.

Community Agreement

I agree to respect confidentiality, personal boundaries, instructor guidance, and the retreat community. I agree to be kind, inclusive, and respectful, and to avoid illegal drugs, unsafe behavior, or disruptive conduct.

Dismissal Policy

I understand that the host reserves the right to dismiss a participant who violates community guidelines, creates safety concerns, or disrupts the retreat environment, and that dismissal may occur without refund.

Photo & Media Release

Yes — I give permission for my image to be used in future retreat marketing, website content, or social media.

No — Please do not intentionally include me in photos or videos.

Payment, Cancellation & Refund Policy

I understand that either a $100 deposit or full payment is required to reserve my spot for the Peaceful Power Retreat. If I choose the deposit option, I understand that my remaining balance is due by June 10, 2026. If the remaining balance is not paid by that date, my reserved spot may be released and my $100 deposit may be forfeited. I understand the cancellation policy: cancellations made more than 14 days before the retreat receive a full refund, minus any non-refundable deposit already stated at registration; cancellations made 14 days before the retreat through 8 days before the retreat receive a refund minus a $100 non-refundable deposit; cancellations made 7 days or less before the retreat are non-refundable. Approved transfers may be allowed at the host’s discretion. If the host cancels the retreat, participants receive a full refund of all payments made.

Travel, Belongings & Insurance Agreement

I understand that I am responsible for my own travel arrangements, transportation, and personal belongings.

Final Participant Agreement

I have read and agree to the retreat policies, participation agreements, health acknowledgments, waiver, and payment terms. I understand that checking this box and submitting payment serves as my agreement to these terms.

Typed Full Legal Name

Date

You may reserve your retreat spot with a $100 deposit today, or pay in full now. If you choose the deposit option, your remaining balance is due by June 10, 2026. Dorothy will follow up with balance payment details after registration.

Choose a registration package above to see your payment total.

Pay with Card (Stripe)

By registering, you acknowledge the Privacy Policy. Questions before registering? Ask Dorothy here.