Planting the Seeds of Hope

Ovarian & Gynecologic Cancer Survivor Retreat

Friday, September 20 – 10:00 am to
Sunday, September 22 – 10:00 am

Planting the Seeds of Hope

Join us for a 3-day retreat where you have time to focus entirely on yourself. Our goal is to help reduce stress by exploring ways to find renewal and healing. In a group setting, we’ll dive into how to find meaning, hope, joy & grace after a diagnosis of advanced-stage cancer. Throughout the weekend, you will have opportunities to explore how meditation, a gentle yoga practice, journaling, or spiritual practice can enhance your life. We’ve left space for you to rest, socialize, or explore nature on the grounds of the beautiful Asbury Retreat Center campus.

SIGN UP DEADLINE: THURSDAY, AUGUST 29TH, 2024

Reservation Application below. Questions? Please Call Us at 716-458-0382 or email Kathleen Maxian at [email protected]

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Who:

Open to women with

newly diagnosed ovarian or gynecologic cancer that received treatment or
ovarian or gynecologic cancer that has recurred.
Gynecologic Cancers include ovarian, primary peritoneal, fallopian tube, endometrial/ uterine, cervical, and vulvar.

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Accommodations:

We’ll be staying at the Asbury Retreat Center in Silverlake, NY . Meals include lunch & dinner on Friday, breakfast lunch & dinner on Saturday, and breakfast on Sunday. There will be a cold beverage and snack service daily.

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Cost:

$100 plus a $100 refundable deposit.

Space for this retreat is limited to 30 women and will sell out.
The deposit is 100% refunded for retreat participants.
The deposit is 100% refundable for individuals who withdraw before August 25th.
The final $100 payment is due September 8th.

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Scholarships

We know having cancer is expensive. Don’t let cost keep you from participating. Limited (confidential) scholarships are available. Please call or email Kathleen at 716-458-0382 or kmaxian@ OvarianCancerProject.org

Space is limited; ensure your spot today!

Name(Required)

First Last

*I have been diagnosed with Advanced Stage: Ovarian, Primary Peritoneal, Fallopian Tube, Endometrial, Cervical or Other Gynecologic Cancer(Required)

Month and year of diagnosis(Required)

Please tell us the type of cancer(Required)

What type?(Required)

What Stage Cancer?(Required)

What month & year where you originally diagnosed(Required)

My cancer has recurred(Required)

Yes

If yes, when?(Required)

Have you ever attended an cancer retreat?(Required)

Yes

If yes, where and when?(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Preferred Phone(Required)

Alternative Phone

Email(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

What is your emergency contact's relationship to you?(Required)

How did you hear about this retreat?(Required)

Do you have any dietary restrictions?

Is there anything else you’d like to tell us?

PLEASE READ CAREFULLY, UNDERSTAND FULLY, AND ASK QUESTIONS IF ANYTHING IS UNCLEAR. WE ARE HERE TO SUPPORT YOU. BY SIGNING THIS, YOU AGREE, AND YOU AGREE TO BE BOUND BY ALL THE TERMS OF THIS AGREEMENT.

Consent(Required)

I acknowledge reading the agreement below

AGREEMENT

The WNY Ovarian Cancer Project (OCP) extends a warm welcome to our retreat participants. We ask that during the retreat you agree to the follow the SAFETY PRECAUTIONS and GUIDELINES (COVID-19 Protocols) set forth by the Centers for Disease Control & Prevention (CDC), Wyoming County, and the Ovarian Cancer Project and Asbury Retreat Leadership.

I agree that I will not attend the retreat if I feel sick or ill. Masks are optional.

We encourage you to be FULLY VACCINATED for COVID and have had the FLU Vaccine. Please contact your medical provider to make sure the vaccines are right for you.
"Fully vaccinated" means two Pfizer or Moderna vaccinations (or one Johnson & Johnson vaccine) plus available BOOSTER vaccines.
Upon arrival, I agree to take a COVID test (home test kit style) which will be provided as an extra layer of protection. Anyone not completing these steps (or having adverse response outcomes) will not be able to enter and participate in the retreat.

RELEASE & LIABILITY WAIVER

I agree to release the WNY Ovarian Cancer Project, staff, volunteers, and consultants of any liability during the RETREAT. Please be aware that if you do not sign this Waiver and agree to its terms, you will not be permitted to participate in the retreat.

PLEASE READ CAREFULLY, UNDERSTAND FULLY, AND ASK QUESTIONS IF ANYTHING IS UNCLEAR. WE ARE HERE TO SUPPORT YOU. MAKE SURE YOU UNDERSTAND THIS WAIVER. BY SIGNING THIS, YOU AGREE, AND YOU AGREE TO BE BOUND BY ALL THE TERMS OF THIS AGREEMENT.
1. Parties. We will refer to WNY Ovarian Cancer Project, Inc., a corporation registered in the State of New York, as "Ovarian Cancer Project," "OCP," "us," or "we" or "our," and we'll refer to you, the undersigned (electronically or by hand) or person who has clicked "I Agree" to this Waiver, as "you" or "your."
2. The Activities. All activities associated with the Retreat, including but not limited to yoga, walking, or hiking on the grounds of the Asbury Retreat Center. We offer various levels of yoga, all of which may involve but are not limited to the following ("Activities" ):
2.1 Stretching and flexibility training in the form of yoga poses, body weight and strength exercises, breathwork, meditation, and relaxation. The constant in all of these classes is that the activities involve stretching and performing yoga poses.
2.2 The Activities performed as part of our sessions include self-practice hours/sessions that may be unsupervised, and therefore we need you to acknowledge that you practice at your own risk.
3. Equipment. In the course of the Activities, you will use a variety of equipment, which may include but is not limited to: blocks, bolsters, straps, mats, resistance bands, and pillows (the "Equipment"). Please do not use any equipment not instructed by the Ovarian Cancer Project.
4. Inherent Risks. You understand that participating in the Activities poses inherent risks, some more obvious/serious than others.
5. Affirmation of Health. By participating in any retreat Activities with the Ovarian Cancer Project, you affirm that you have sought medical advice regarding your fitness to attend the retreat or are certain of your ability to participate in yoga. If you have any pre-existing medical conditions (e.g., cancer, asthma, diabetes, heart disease), physical injuries, weakness, or post-surgery, you should consult your doctor first before engaging in the Activities. Please communicate and inform us IMMEDIATELY if at any point you do not feel well during the Activities.
6. Voluntary Assumption of Risk. You have read this Waiver and understand the risks of participating in the Activities with the Ovarian Cancer Project. Your signature below, electronic signature or clicking 'I Agree,' and your participation in the retreat of the Ovarian Cancer Project illustrate your voluntary engagement and assumption of the risks of the Activities.
7. Release, Waiver, and Indemnity. You hereby release, hold harmless, indemnify and waive any claims against the Ovarian Cancer Project, its members, directors, officers, contractors, employees, volunteers, agents, executors, administrators, successors, family members, and assigns (the "Released Parties") from any liability and damages arising from personal injuries, however, caused including as a result of the Ovarian Cancer Projects negligence, during your participation in the Activities with the Ovarian Cancer Project. You are releasing the Released Parties at your own risk, and you agree to forfeit any and all forms of legal recourse.
8. Continued Agreement. Agreement to this Waiver will act as your continued Agreement to
9. General Legal Provisions. Jurisdiction. This Waiver will be governed exclusively by the laws of the State of New York. Severability. If any provisions of this Waiver are invalid or unenforceable, the other provisions in the Waiver will remain in full force and effect. Entire Agreement. This Waiver constitutes the entire Agreement between the parties and replaces any prior agreements. Headings. The headings used in this Waiver are for stylistic purposes only, and none of the content in the headings are intended to be legally binding. Online Agreement. We agree that this Agreement may be signed electronically or agreed to by having you click "I Agree," the effect of which will be the same as signing by hand and the intention of which is that both parties desire to be bound by all the terms of the Agreement.
You've agreed that you have read this Waiver and fully understand its contents and voluntarily agree to be bound to all of its terms.

Download and Print Agreement

Agreement Signature(Required)

After you complete your registration, you will receive an emailed receipt and a second email confirming your registration. Within a few days of your registration, we schedule an introductory phone call with you, to get to know a bit more about your journey. We'll also send you a list of what to bring with you to the Retreat.

Space is limited; ensure your spot today!

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Payment Options(Required)

I'd like to pay my $100 deposit now.

I would like to pay both my $100 refundable deposit & $100 (full cost of the retreat) now

I'll send a check

I would like to apply for a scholarship; please contact me.

Please make the check payable to:

"Ovarian Cancer Project” in the amount of $100 (note Deposit) or $200 (note payment in full).

Mail to:

Ovarian Cancer Project
P.O. Box 1002
Williamsville, NY 14221

*August 25th, 2023, is the deadline to withdraw without losing your deposit. Participant full deposits will be issued the week of September 25th.

Registration Deposit

Price:

* August 25th, 2023, is the deadline to withdraw without losing your deposit. Participant full deposits will be issued the week of September 25th.

Full Registration

Price:

* August 25th, 2023, is the deadline to withdraw without losing your deposit. Participant full deposits will be issued the week of September 25th.

Donation

I'd like to make an additional donation to help cover the cost of the retreat.

Donation Amount

Transaction Fees

I'd like to cover the fee for this Transaction

Transaction Fee

Price: $0.00

Total

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