Pat T. Nixon Enterprise

Your journey to self discovery starts here

First name*

Last name*

Email*

Cell phone number*

Mailing Address*

Birthday*

Month

Day

Year

FB or Social Media Handle*

Do you currently have a passport?*

Yes

Are you or your company interested in being a sponsor at the R³ 2026 Women's Retreat?*

Yes

Your t-shirt size*

XXL

Other

How did you hear about the R³ 2026 Women's Retreat?*

Facebook

Instagram

Google Search

Pat T. Nixon

Other

Why do you feel committed to attending the R³ 2026 Women's Retreat?*

How do you currently prioritize self-care and refueling in your busy schedule? (Share one specific practice or activity that rejuvenates and refuels your energy.)*

What habits or thought patterns do you currently find challenging or hindering in your professional and personal life? (List 2-3)*

What aspects of your work or personal life ignite your passion and inner fire?*

What specific accomplishment or moment are you most proud of in your personal or professional journey?*

How do you envision contributing value to the retreat community?*

I am committed to bossing up in this world.*

Yes

I am committed to refueling myself so that I can be the best version of me at all times.*

Yes

Have you attended a R3 Retreat before?*

Yes

Are you able to invest $2500-$5000 in YOU this year?*

Yes

Choose Your Payment Schedule

Deposit

Full-Payment

bottom of page