Form cover
Page 1 of 1

Application for Roots to Riches Retreat with Michele Laine and Holly Starr Allen

Apply now to be considered for the October 2025 retreat in Mt. Shasta with Michele Laine & Holly Starr Allen.

This is a high-touch, energetically curated experience. Your responses help us co-create a safe, powerful space with women who are truly ready to rise.

We invite you to please take a moment, ground in, and share from the heart.


1. Introduce Yourself
Where are you located, and what would you like us to know about who you are in this season of your life?

2. What shift are you currently craving, and why do you feel now is the time?

3. What part of your current identity or chapter are you ready to release or evolve beyond?

4. Have you worked with healing or transformation modalities before?
Examples: Human Design, Numerology, energy work, shadow work, coaching, somatics, etc.

5. How do you typically navigate emotional or inner work? Are you open to vulnerability, reflection, and being witnessed in a group space?

6. If you could walk away with one massive shift from this retreat, what would it be?

7. What is your current relationship with wealth, visibility, or receiving?
Are there patterns you're ready to release or energies you desire to embody?

8. Which experience are you most drawn to?
(We understand this may evolve, but it helps us understand your current preference.)

8. Which experience are you most drawn to?(We understand this may evolve, but it helps us understand your current preference.)
A
B
C

9. If accepted, which option would you prefer?

9. If accepted, which option would you prefer?
A
B
C

10. Were you referred by someone?
We’d love to thank them! (Please include their name if so.)

11. Is there anything else you’d like to share from your heart?

First Name

Last Name

Email

12. Optional: Upload a short video (3–5 min)
You may answer the questions above or simply share your intention and energy.

Upload Your Video Submission Here:

Thank you for applying with intention. This application does not guarantee a spot. If your energy aligns with this round of Roots to Riches, we will personally reach out to invite you in.


Thank you for applying with intention. This application does not guarantee a spot. If your energy aligns with this round of Roots to Riches, we will personally reach out to invite you in.