couples application form
places are limited for this retreat, the information you provide here will help us decide if you are in alignment for this truly transformational retreat
APPLY
tell us a bit more about yourselves
ie; how long you've been together, what/if any differences you have, what you love to do together, what you would like more of etc
what is your main reason / goal for coming to this retreat?
ie. reconnecting, exercise, mindfulness, stress relief, relaxation, save our relationship, other
ie. reconnecting, exercise, mindfulness, stress relief, relaxation, save our relationship, other
HAVE you practiced any of the following? (Please list)
Yoga, meditation, breathwork, walking, sound healing, cacao ceremony,
cold water swim, dance
Yoga, meditation, breathwork, walking, sound healing, cacao ceremony,
cold water swim, dance
Have you attended a retreat?
How did you hear about us?
do you have any injuries?
EMAIL
phone
address
surname
given name
do you have any injuries?
EMAIL
PHONE
ADDRESS
SURName
GIVEN Name
celebrating you
we are humbled that you've chosen to
honour yourselves
your process of transformation is now initiated
we will review your application and get back to you to discuss the next steps as soon as possible, we look forward to connecting with you soon