2023 Wellness Retreat Deposit Form

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Full Name* This field is required.
First Name
Last Name
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Spouse or Partner's NamePlease list your spouse or partner who you will be traveling with if registering for 2 People
First Name
Last Name
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E-mail* This field is required.
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Contact Number* This field is required.
Area Code
Phone Number
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Are you able to receive text reminders?* This field is required.
Yes
No
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Gender* This field is required.
King
Queen
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Are you an entrepreneur or business owner?* This field is required.
Yes
No
Thinking About It
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T-Shirt Size* This field is required.
Small
Medium
Large
X-Large
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What Generation Were You Born In?* This field is required.
Alpha (2011 & Up)
Gen Z (1995-2012)
Millennial (1980-1994)
Gen X (1965-1979)
Baby Boomer (1946-1964)
Silent (1925-1945)
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Ethnicity* This field is required.
Black/African American
Caucasian
Native American
Asian/Pacific Islander
Latin American/Hispanic
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Do you have a referral for the trip?If you refer any friends, family or loved ones before February 15th you will receive $250 off (1 per person)
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Do you have a current passport?* This field is required.Does not expire within 6 months of August 2023
Yes
No
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Have you traveled to Central America before?* This field is required.
Yes
No
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Picture UploadPlease upload a headshot or picture of yourself or as a couple for marketing purposes
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Max. file size: 10.6MB
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Any Special Accommodations
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Terms and Conditions* This field is required.All Trip Deposits Are Non-Refundable
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Trip Deposit OptionsA deposit secures your spot on the trip. Future payment invoices will be sent via email to complete your full payment unless you take advantage of for the Early Bird Special Packages Below
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ORDER SUMMARY
Total costUSD
Trip Deposit $500 for 1 Person (Flight, Travel Insurance & Visa Not Included) Ready to start your Wellness & Healing going into 2023 on a high note? With only a $500 deposit by February 28th, 2023 you can save your spot on the Smart Wellness & Healing Retreat ! Deposits are non-refundable unless trip is cancelled due to circumstances beyond our control. Flight arrangements, passports, visas, travel insurance, ground transportation, and immunizations are not included.
$500.00+Edit
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Trip Deposit $1,000 for 2 People (Flight, Travel Insurance & Visa Not Included) Ready to start your Wellness & Healing going into 2023 on a high note? With only a $1,000 deposit by February 28th, 2023 you both can save your spot on the Smart Wellness & Healing Retreat ! Deposits are non-refundable unless trip is cancelled due to circumstances beyond our control. Flight arrangements, passports, visas, travel insurance, ground transportation, and immunizations are not included.
$1,000.00+Edit
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Early Bird Special Full Package $2,250 for 1 Person (Flight, Travel Insurance & Visa Not Included) Ready to start your Wellness & Healing going into 2023 on a high note? Get in on our early bird special! With only a $2,250 (includes deposit) full payment by February 28th, 2023 you can save your spot on the Smart Wellness & Healing Retreat! This package includes retreat accommodations, food, thermal treatment, welcome kit and more! Flight arrangements, passports, visas, travel insurance, ground transportation, and immunizations are not included. Deposits are non-refundable unless trip is cancelled due to circumstances beyond our control.
$2,250.00+Edit
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Early Bird Special Full Package $4,500 for 2 People (Flight, Travel Insurance & Visa Not Included) Ready to start your Wellness & Healing going into 2023 on a high note? Get in on our early bird special! With only a $4,500 (includes deposit) full payment by February 28th, 2023 you can save your spot on the Smart Wellness & Healing Retreat! This package includes retreat accommodations, food, thermal treatment, welcome kit and more! Flight arrangements, passports, visas, travel insurance, ground transportation, and immunizations are not included. Deposits are non-refundable unless trip is cancelled due to circumstances beyond our control.
$4,500.00+Edit
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Total cost $0.00
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