SayPro Registration Form A form to capture essential details such as participant contact information, experience level, and specific personal development goals.

SayPro Personal Development Retreat – Registration Form

Please complete this form to register for the SayPro Personal Development Retreat. Your responses will help us tailor the retreat experience to your needs.

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1. Personal Information

• Full Name: ______________________________________
• Date of Birth: ___________________________________
• Gender: ☐ Male ☐ Female ☐ Non-Binary ☐ Prefer Not to Say
• Email Address: __________________________________
• Phone Number: __________________________________
• Country & City of Residence: ______________________

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2. Emergency Contact Information

• Emergency Contact Name: ___________________________
• Relationship to Participant: ________________________
• Emergency Contact Phone Number: ___________________

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3. Experience Level & Background

• Have you attended a personal development retreat before?
  ☐ Yes ☐ No
• What is your current level of experience in personal development?
  ☐ Beginner (just starting)
  ☐ Intermediate (some experience)
  ☐ Advanced (regularly practice personal development techniques)
• Which topics have you explored before? (Check all that apply)
  ☐ Emotional Intelligence
  ☐ Leadership Skills
  ☐ Mindfulness & Well-being
  ☐ Goal-Setting & Motivation
  ☐ Communication & Public Speaking
  ☐ Time Management & Productivity
  ☐ Work-Life Balance
  ☐ Other: _______________________________

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4. Personal Development Goals

• What are your top 3 personal development goals for this retreat?
• What specific challenges or areas of growth would you like to focus on?
  ☐ Building Confidence
  ☐ Managing Stress & Anxiety
  ☐ Improving Communication Skills
  ☐ Strengthening Leadership Abilities
  ☐ Enhancing Emotional Intelligence
  ☐ Increasing Productivity & Time Management
  ☐ Creating Work-Life Balance
  ☐ Other: _______________________________

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5. Participation Preferences

• What format do you prefer for learning? (Check all that apply)
  ☐ Interactive Workshops
  ☐ Group Discussions
  ☐ One-on-One Coaching
  ☐ Self-Reflection & Journaling
  ☐ Practical Exercises & Role-Playing
  ☐ Other: _______________________________
• Do you have any accessibility needs?
  ☐ No ☐ Yes (please specify) _______________________________
• Do you have any dietary restrictions or allergies?
  ☐ No ☐ Yes (please specify) _______________________________

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6. Additional Information

• How did you hear about this retreat?
  ☐ SayPro Website
  ☐ Social Media
  ☐ Email Newsletter
  ☐ Friend/Referral
  ☐ Other: _______________________________
• Any additional comments or special requests?

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7. Consent & Agreement

☐ I confirm that all information provided is accurate.
☐ I agree to participate fully in the retreat activities.
☐ I understand that my personal data will be used only for event-related purposes.

Signature: ___________________________ Date: ______________

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Submit Your Form

📩 Email: [Insert SayPro Email]
🌐 Online Registration: [Insert SayPro Registration Link]

Thank you for registering! We look forward to your journey of growth with SayPro! 🚀