Camping Retreat - July 25-28, 2019

REGISTRATION:

Thriving in the Woods
Camping Retreat - Panther Creek
Near the Pacific Crest Trail
(July 25-28, 2019)
First Name:*
Last Name:*
E-mail:*

Confirmation Email
Phone Number:*

Area CodePhone Number
City:*
State or Province*
Postal Code:*
Country*
What day and time do you plan to arrive? (6:30pm Thursday earliest)
What day and time do you plan to depart? (4:30pm Sunday latest)
How did you hear about this event?

Thriving Life emailFrom a Friend, Family Member, Neighbor, Colleague, Therapist, etc. (please specify below)Internet Search (Google, Yahoo, Ask, etc.)Facebook Page for this eventFacebook page - Presence PracticeFacebook page - Vika's ThrivingLife pageFacebook page - Thriving Life InstituteThriving Life NVC WebsiteCNVC WebsiteORNCC NVC WebsiteORNCC NVC NewsletterSacred Circle Dance listOther (please specify below)
What "other" way, or through whose recommendation, did you FIRST hear about Vika or Thriving Life?
Do you have any experience with NVC? (none is required!)

NoI've just heard about it, and I'm curiousI've read at least part of "the book" - NVC A Language of Life, by Marshall RosenbergI've taken a workshop or classI've participated in an NVC Practice Group of some kindI've taken classes &/or workshops, AND participated in an NVC Practice Group (less than 1 year)I've taken classes &/or workshops, AND participated in an NVC Practice Group (1-3 years)I've taken classes &/or workshops, AND participated in an NVC Practice Group (more than 3 years)I've taught NVC
Do you have any experience with Vika's Thriving Life work? (please check all that apply)*

No, this will be my first eventI've watched the "Broken Toe" free videoI've watched the "Secret to Happiness 101" Thriving Life NVC free overview videoI've watched the "3 Elements of Healthy Boundaries" free videoI've watched one or more of Vika's other videosI've attended a Thriving Life NVC Free IntroductionI've attended the Thriving Life Fundamentals Seminar, Solve the Mystery of your "People Problems"I've participated in one of Vika's classes or workshopsI've participated in Compassionate Noticing (or Shared Witnessing)I've participated in the Presence Practice GroupI've participated in Thriving Life social eventsOther
Are you a mental health, personal development, or other helping professional serving the public?*

NoYes, I'm a mental health professionalYes, I'm preparing for a career as a mental health professionalYes, I'm a coach or other personal development professionalYes, I'm preparing for a career as a coach or other personal development professionalYes, other (please specify below)
What "other" helping professional role do you have?
In what ways are you hoping this retreat will contribute to your thriving?*
What topics would you love for us to cover during the weekend? We'll have three times during the weekend when we'll have a community conversation (for all who are delighted to join) about topics that YOU and your fellow campers choose. Some examples might include, "Managing Reactivity and Calming Our Brains," "Healing Relationship Pain (even violence and abuse)," "How to Set Healthy Boundaries," and "What Do We Really Mean by [Safety, Respect, Trust, or other '4-letter' Words]?"*
What are 3 situations where you find it the most challenging to live from what's alive? That is, when it's hard for you to say or do what feels most true, authentic, or right for you?*
What are 3 situations where you lose your capacity for presence, compassion, and authentic choice?*
How will you get to the campground? (If you drive, please add $9 PER NIGHT to your tuition contribution. If you offer rides to others, we'll ask them to share gas and parking fees with you.)*

I'll drive my own car (on my own)I'll drive my own car and give a ride to a friend (alas, no room for more people)I'll drive my own car and can offer a ride to someone else (please let us know how many you have room for, in the carpool comment section below)I might drive my own car, or I might carpool as a rider with someone else -- I'm not sure yetI'll carpool in someone else's car (please remember to share gas and parking fees with your driver!)
I'm carpooling with [name]:
PARKING FEES (driving your own car): How much will you add to your tuition, to cover parking fees for your car? ($9 per night: 3 nights = $27; 2 nights = $18)
CARPOOLING: Ideal pickup time and location (whether you're a driver or a rider)
CARPOOLING: Ideal dropoff time and location (whether you're a driver or a rider)
Is there anything else you'd like us to know about your carpool offer or receiving needs?
What camping option are you choosing?*

I'm registering and tenting with friends (please let us know who will tent with you below)I'm registering with friends and tenting on my ownI'm registering and tenting on my ownOther
If you'll be sharing your tent with friends, please let us know their names.
What are the dimensions of the part of your tent that touches the ground? (For example, "X feet by Y feet") If you'll be sharing someone else's tent, please write "SHARE."*
At what time do you imagine you'll get up in the morning? At what time do you imagine you'll go to bed at night? (We'll match early risers at one campsite and late to bed folks at another, so everyone gets the rest they want!)
What's your preference around camping at the main site (a double campsite where all our gathering will be held)?

I prefer itIt's okayI prefer not to camp at the main siteOther
Please select the sliding scale contribution that applies to you:
- $195-$225 sliding scale – register and share a tent with friends (save $50 each)
- $220-$320 sliding scale – register with friends and tent alone (save $25 each)
- $245-$345 sliding scale – register on your own and tent alone
- Please add $9 per day, per car
Please select the EARLY BIRD sliding scale contribution that applies to you:
- $175-$275 sliding scale - register and share a tent with friends (save $100 each)
  $200-$300 sliding scale - register with friends and tent alone (save $75 each)
  $225-$325 sliding scale - register on your own and tent alone (save $50)
- Please add $9 per day, per car
Please add $9 per day, per car
Please select the EARLY REGISTRATION SPECIAL sliding scale contribution that applies to you:
- $145-$245 sliding scale - register and share a tent with friends (save $130 each)
- $170-$270 sliding scale - register with friends and tent alone (save $105 each)
- $195-$295 sliding scale - register on your own and tent alone (save $80)
- Please add $9 per day, per car
Please select the SUPER EARLY BIRD sliding scale contribution that applies to you:
- $125-$225 sliding scale - register and share a tent with friends (save $150 each)
- $150-$250 sliding scale - register with friends and tent alone (save $125 each)
- $175-$275 sliding scale - register on your own and tent alone (save $100)
- Please add $9 per day, per car
What sliding scale contribution are you offering for this event? (Please remember to add $9 PER NIGHT if you'll be bringing a car.)*
(include $9 PER NIGHT, per car)
If you're registering with others, please let us know their name(s), so we can match their registration form with yours. (Please be sure they register within 14 days of you, to qualify for the "register with friends" discount.)
We're listening! Is there anything else you'd like us to know?
We're delighted you'll be joining us!

To complete your registration and submit your full tuition contribution, click the "submit" button below.

Please add thrive@thrivinglifenvc.org and vika.thrivinglife@gmail.com to your "safe senders" email list, and watch your inbox, promotions tab, or spam filter for your confirmation email.

I look forward to meeting you!

Warmly,

Vika Miller, MA
Thriving Life & Community
503-395-5366
thrive@thrivinglifenvc.org
www.thrivinglifenvc.org
www.facebook.com/thrivingvillageinternational
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