The Bridge 2010 Application Form

The Pescadero Bridge 2010 Application Form

Bridge Logo

On behalf of the Organizers and Facilitators of The Bridge, we thank you for giving yourself this 4-day gift of deep self-exploration with your fellow men. To say you have stepped off the precipice just scratches the surface of what is available to you during your participation in The Bridge. Our role is to facilitate the realization of your deepest truth as you join us during this ritual event.

* Last Name:

* First Name:

Middle Initial:

* Address - Street # and Street:

* City:

* State:

* Zip Code:

* Cell Phone Area Code:

* Cell Phone #

Home Phone #:

* Age:

Questions:

Please take some time to answer the following questions. This information will be held in strict confidentiality and is asked simply that we may serve you and your health in the best possible way.

* Are you taking any prescription drugs?

If yes, please list:

* Do you have any special food preferences, anything you don’t eat? (For example, are you a vegetarian?) Please be specific so we may provide foods that support you.

* The Bridge can be physically challenging at times. For example, on one of the days of the event, you may be asked to fast, drinking only water. We may undertake a sweat lodge, enduring extreme heat for a long period of time. Some of the individual and group processes can be quite intense, both physically and emotionally? Is there any reason you feel you may not participate in all of the activities due to health reasons? If so, please provide some detail so we may accomodate your situation most appropriately.

* Why have you chosen to participate in The Bridge? Please be as specific as possible.

* What would you say are your greatest challenges in life? Another way to put this is, what currently causes you the greatest suffering? Please be as specific as possible.

* What brings you the most joy in your life? Please be as specific as possible.

* What would you say is your mission in life, your reason for being? What are your gifts, and where in your life do you feel you can most frequently share your gifts? Please be as specific as possible.

* What would you like achieve as a result of your participation in The Bridge? Please be as specific and self-ish as possible.

Please read before clicking the Submit button:

The Bridge Event will take place July 21st (Wednesday night) to July 25th (Sunday night), 2010. You will need to arrive by 5PM on Wednesday, July 21st. The event will end between 6-8PM on Sunday night. You may stay on through Monday morning, and leave no latter than 8AM.

The price for The Bridge is $995. There is a residential fee (mandatory) of $150 for lodging. A deposit of $575 is required to secure your spot. Payments may be made through Pay Pal to the email address of jay.cradeur@gmail.com. Or, you may mail a check made out to: Empower Quest Services, 708 Gravenstein Hwy N #208, Sebastopol, CA 95472.

Thank you and Welcome to The Bridge.

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