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Breathe Colombia: Application
Please complete and submit the following application.
29
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1
Full Name
*
This field is required.
Our retreats are small and intimate. Therefore, to create the ideal safe space during these Covid times, ensuring a positive wellness experience for each guest, we have a short application process to group together like-minded individuals. Kindly complete the following questions, and someone from our team will contact you with further instructions to secure your spot for Breathe Colombia. Upon accepting your application, we will forward you a link to make your initial deposit of $500. Thank you for your interest!
First Name
Last Name
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2
Age
*
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3
Gender (how you identify)
*
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4
What are your
pronouns
?
*
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5
Current Location (City, State, Zip Code & Country)
*
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6
Email Address
*
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example@example.com
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7
Phone Number
*
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Please enter a valid phone number.
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8
Why are you interested in attending Breathe Colombia?
*
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9
In which package are you interested?
*
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Please Select
Package 1
Package 2
Package 3
Package 4
Package 5
Package 6A/6B
Please Select
Please Select
Package 1
Package 2
Package 3
Package 4
Package 5
Package 6A/6B
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10
If you are traveling with someone or already have a roommate in mind, kindly enter their name below.
*
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11
All of our retreats are co-ed. Are you comfortable attending a co-ed wellness retreat?
*
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YES
NO
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12
How did you hear about our retreats?
*
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13
What does wellness travel look like for you?
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14
What are three things you hope to gain from Breathe Colombia?
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15
What needs to happen before year-end for this to be a successful year for you?
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16
How do you think this retreat will propel your passions, health goals, and vision?
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17
Is this your first international experience?
*
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YES
NO
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18
What is your favorite travel destination and why?
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19
How would you describe yourself in a group setting?
*
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The introvert
The social butterfly
The phone scroller
The at first I'm shy, then I warm up
The loud one
The adventurous one
The organizer
The crowd pleasure
The seriously chill, go with the flow
The introvert
The social butterfly
The phone scroller
The at first I'm shy, then I warm up
The loud one
The adventurous one
The organizer
The crowd pleasure
The seriously chill, go with the flow
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20
Have you done group travel before?
*
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YES
NO
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21
Please provide your social media handle, IG, FB, Twitter, LinkedIn, etc.
*
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22
Are you following us on IG and FB?
*
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We greatly appreciate your support.
YES
NO
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23
Do you have any food allergies, dietary restrictions, or follow a specific eating pattern? If yes, please explain.
*
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24
How would you describe your fitness level?
*
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Beginner
Intermediate
Advanced
Beginner
Intermediate
Advanced
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25
Have you taken a yoga class before? Please describe your level of experience.
*
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26
Do you have any injuries? If yes, please explain.
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27
Have you received or planned to receive the Covid-19 vaccine?
*
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YES
NO
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28
Is there anything else you want us to know?
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29
Please verify that you are human
*
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