Rebirth Container Application

Name *

First Name

Last Name

Please select the Rebirth support option you're considering *

Rebirth: 3-Month 1:1 Container

Rebirth: 1-Month Intensive

Rebirth: 6-Month Deep Immersion

Rebirth: 3-Month + In-Person Immersion in Taos

The investment is $5000 total for 3 months. What payment option will work best for you? *

(Please note: If you’re applying for the 1-Month Intensive, 6-Month Deep Immersion, or Rebirth + In-Person Immersion, pricing will be discussed during our consult call.)

Pay in Full

I'd like to discuss payment plan options

I’m interested in a different Rebirth option and would love to talk more about the investment.

Are you wanting to add an in-person immersion in Taos to your container?

By adding an Immersion to your 1:1 container, you receive a bundled discount when paired together.

Yes I'd like to also add an immersion!

I'm curious to discuss this option with you

Not at this time - Just the 1:1 Container

Lastly, would you like to book a 30-minute discovery call with me to go over any questions or concerns you may have before starting the container?

Yes, I will book a call with you through the scheduling link below

No, I have already connected with you extensively and don't need a call to move forward