Winter Escape 2019 Prep Assignment Winter 2019 Escape Prep Assignment In a private sacred space, deeply connected to yourself, please answer the following. Answer honestly. The more you put into this assignment the more you will receive during our time together. If at any point you are not sure how to answer, guess. Always go with what resonates with you. This is not a test. Simply share whatever is true for you! Name* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 1) Look back over the last 6-12 months in your relationship with food, your body and your life. Note everything that has changed externally and in the physical tangible world for you. List out everything you’ve accomplished externally. Don’t hold back. List it all out. (For example, think about what seems “normal” that last year was just a thought or didn’t even exist.)*2) Look back over the last 6-12 months in your relationship with food, your body and your life. Note everything that has changed internally and in your mental and emotional world for you. List out everything you’ve accomplished internally. Don’t hold back. List it all out. (Examples: you feel more grounded, peaceful, confident, clear)*3) If you attended either the Spring or Fall ESCAPE in 2018, what been the biggest change/accomplishment for you as a result of our in-person time together? (look for the thing that would have never shifted if we hadn’t been together on that retreat.)*4) Why have you chosen to make healing your emotional eating a priority by attending the Winter ESCAPE?* 5) Please set your intentions for The ESCAPE:5a) How do you want to feel at the close of our Escape time together?*5b) What is 1 tangible you want to walk away with?*5c) What would you like to see shift 6-months after the Escape because of our retreat time together?*6) What do you expect to receive from being in person with this powerful community of like-minded individuals?*7) Give an example of how each of the following energies are currently showing up in your relationship with food:7a) Fear*7b) Perfectionism*7c) People pleasing*7d) Judgement of self (and others)*8) When these energies are present, what does it feel like in your body? Give a specific description for each:8a) Fear*8b) Perfectionism*8c) People pleasing*8d) Judgement of self (and others)*9) When it comes to these specific energies and their impact on your physical, mental, emotional and spiritual health, what do you want?10) Currently, what is your biggest challenge when it comes to being free from emotional eating? What keeps getting in your way, stopping you or slowing you down? Provide as much detail as possible.*11) How you do one thing is how you do everything. So what patterns in your relationship with food and your body are repeating themselves in the other areas of your life - such as your energy, time, money, and relationships with others?*(please note: “nothing” is not an answer)12) How do you learn best? (please select your top 2) * a) I am a visual learner. It’s helpful for me to see things in images, diagrams and handouts. b) I a kinesthetic learner. I learn best by moving and doing. I like to use my body, hands or sense of touch. c) I am an auditory learner. It’s helpful to have things explained to me in a slow methodical way in a lecture type style. I also like to talk things out. d) I learn best with a tutor. I like private one-on-one support where we can go at my own pace and I can ask as many questions as needed. 13) Do you have any food, environmental or other allergies or sensitivities that we need to be aware of to ensure a peaceful supportive learning environment?*14) Is there anything else I need to know to be of highest service to you?*15) Be familiar with the Escape From Emotional Eating Foundational Trainings (1-9) and be prepared to discuss these foundational tools in-person.* OK! I will do that! 16) February in Cape May is a powerful time to retreat as it is the off-season. Yet, this also means many of the restaurants will be closed or have limited hours. To best support you and the transformation we will be creating together, Jessica has decided to provide you with dinner on Monday and Tuesday evening. This is her gift to you and is optional. So we can best coordinate this with the hotel, please let us know which, if any of the evenings, you will join us for dinner.Monday, February 4* Yes! I’ll be joining you for dinner. Thank you! No, I’ll do my own thing and be back on time for the evening session. Tuesday, February 5* Yes! I’ll be joining you for dinner. Thank you! No, I’ll do my own thing and be back on time for the evening session. I'm still working on this so, I'd like to save for later.