RSVP 2 — Empowering bereaved parents

APPLY TO ATTEND A RETREAT

Thank you for your interest in Ohana Oasis and congratulations on working through the sample exercises. Through this application we’ll get to know a little more about you, your story, and how we can contact you. Please complete and submit the following application.

Hosting each retreat is costly, however we are committed to making retreats available to participants almost completely free of charge.

The average cost of the retreat experience per participant is $1,750. Upon accepting an invitation to participate, you will only be required to pay $125 as a commitment to investing in yourself and the process.

Name

First Name

Last Name

Phone

(###)

###

####

Deceased Child's First Name

Child's Date of Birth

Child's Date of Death

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth for Applicant and Spouse if applicable

Tell us a little bit about your family and network of support.

Please share a brief history of your deceased child, including cause of death and any other details you'd like to share.

What have you (and your spouse) done to work through this loss?

What do you as an individual (and as a couple) seek to gain from the 'Ohana Oasis retreat experience?

What is most important to you (and your spouse) in your healing process presently?

Professional Provider Reference (social worker, counselor, physician, etc) familiar with your situation. Please include name and contact information.

Select

By submitting this applicaiton, you affirm that the facts set forth in it are true and complete. You understand that if you are accepted as a participant, any false statements, omissions, or other misrepresentations made by you on this application may result in immediate dismissal.

Partner name if applicable

First Name

Last Name

How did you find out about us?

APPLY TO ATTEND A RETREAT

Thank you for your support.

Contact ann@ohanaoasis.org
8220 SE 6th Ave. #310
Portland, OR 97202

APPLY TO ATTEND A RETREAT

Thank you for your support.

Contact ann@ohanaoasis.org8220 SE 6th Ave. #310Portland, OR 97202

Contact ann@ohanaoasis.org
8220 SE 6th Ave. #310
Portland, OR 97202