An illustration of the words I Am Hope Survivors Reset Retrea, mountains shaped like breasts with clouds and a river

Nominate

The I Am Hope Survivors Reset Retreat is a four day, three night experience for cancer survivors hosted in the beautiful Coachella Valley. We aim to help survivors get clear on life after cancer and how to move forward. The retreat will be held June 6-9, 2024.

If you'd like to be considered or nominate someone, please fill out the form below.*

Your Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your phone number if we have questions.

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I'd Like to Nominate:

(Please make sure they know you are nominating them.)

Nominee's Gender

Nominee's Name

First Name

Last Name

Nominee's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Nominee's Email

Age at Diagnosis

Nominee's T-Shirt Size

Tell Us in Detail Why You/They should attend the retreat

Please share your/their story with us. How did you/they live in HOPE? What type of cancer? How many years out from active treatment?

Nominee's Social Media Handles ( so we can get in touch with them)

We connect our attendees prior to the event through a private social media group.

Their phone number so we can call them to let them know!

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Nominee's Ethnicity

Occupation

Employer

Total Household Income

How did you hear about The I AM HOPE Survivors Reset Retreat?

What type of cancer did you/they have and date of diagnosis :

Who is your/their oncologist and where were you treated for your cancer?

Please tell us what type of treatment you/they did and for how long?

What type of support did you have/not have during your treatments?

Tell us what your support system looks like post treatment?

Describe any challenges you have had since your diagnosis?

Are you affiliated with any other cancer non-profit or retreat organization?

Yes

If yes, tell us what Non-Profit you are affiliated with and your title.

I confirm that they/ I am finished with active cancer treatment and surgery. I understand I must be at least at least 6 months out from all treatments. All answers in this nomination are correct to the best of my knowlege.

Yes

I am nominating someone else

*I Am Hope Retreat Terms and Conditions

Nominees must be between 1-5 years from active treatment, surgery or if metastatic with doctor’s written approval.

Attendees must be willing to sign a medical waiver and provide proof of doctor’s approval for physical activity, as we will be engaging in some light movement and breath work. All classes will be designed so that everyone can participate with modifications; All activities are optional but your presence is mandatory.

We ask that all attendees be willing to sign a photography waiver. Photos and videos taken during the event may be used in future PR and marketing materials — if you do not wish to appear in any photography during the retreat, please let us know.

Travel costs to/from the retreat are not included; attendees must arrange and pay for their own travel/transportation.

We require a $100 deposit to hold an attendee’s place; the full deposit will be refunded at the end of the retreat. If you cancel before the retreat start date, your deposit will be forfeited.

All survivors ages 18+ are welcome to apply and/or be nominated! We especially encourage people of color and survivors from underserved communities who may not normally have access to this kind of opportunity to be nominated or apply.

Due to limited space, some additional restrictions may apply at the discretion of the Board of Directors of Shay’s Warriors. Nominees are eligible one time for retreat or love bomb, must provide proof of diagnosis from your physician. Shay’s Warriors board of directors and volunteers are not retreat eligible. Nominations close 3/30/2024. All nominees will be notified by April 15th, 2024.