Connie Hertz

Wellness, Lifestyle & Dream Coach | Living in the GLOW

Let’s Get To Know Each Other

We are a small group and cohesive interactions are vital to the success of our unique group during our 7 days and 7 nights together enjoying every aspect of our spiritual retreat.

Let’s begin the discovery process by using this form to help me get to know you and your objectives better.

Mahalo!
~Connie

    Full Name (required)

    Age

    Cellphone

    Your Email (required)

    Current City

    Relationship status

    Who referred you to us?

    Glow Kauai Retreat + You:

    What was it about Glow Kauai Retreat that peaked your interest?

    When was the last time you took REAL time away? (totally unplugged?)

    What gets you most excited about joining us?

    Is this your first retreat? If not, what others have you attended?

    More About You:

    Have you taken any personal growth courses?

    It’s the weekend, what could I catch you doing with a smile on your face?

    What’s your greatest fear?

    What’s your greatest joy?

    What’s your greatest personal goal?

    What’s your greatest spiritual goal?

    A year from now, who do you see yourself becoming?

    As a child, what is something you dreamed of doing or being?

    Name 3 things, you would like to bring more of into your life?

    How would you like your life to look 5 years from now?

    Picture yourself on the Monday after Glow Kauai Retreat ends. What have you accomplished? How are you feeling?

    Any pre-existing physical conditions we should be aware of? Allergies?

    Math Captcha seven + three =