Name
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First Name
Last Name
Email
*
Preferred pronouns
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Date of Birth
MM
DD
YYYY
Country of Residence
Have you previously participated in meditation, mindfulness or self-compassion retreats, programs or training?
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If yes, please describe your previous experience
Have you had any prior experience of yoga or breathwork?
*
If yes, please describe your previous experience
Are there any other previous experiences with relevant practice/s that you would like to share?
*
If yes, please describe your previous experience
What motivated you to apply for this retreat?
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What are your primary goals or objectives for attending this retreat?
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Are there specific aspects of self-compassion or mindfulness that you are particularly interested in exploring?
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Do you have any physical health, mental health or other conditions that we should be aware of?
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If yes, please provide details
Are you currently and/or do you expect you will be taking any medications or undergoing any treatments prior to or during the retreat?
*
If yes, please provide details
Do you have any dietary restrictions or allergies?
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If yes, please provide details
Is there anything else you would like to share regarding your health and wellbeing, that may be relevant to your experience during the retreat?
*
If yes, please provide details
What is your preferred room type?
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Standard
Superior
Deluxe
Pool Suite
If you intend to share a room, please provide details
If you have any questions about the retreat, please note them below
How did you hear about this retreat?
Personal recommendation or word of mouth
Professional recommendation or referral
Social media
Website
Other
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