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Retreat App
Please fill in and submit this form to join the Activate your Feminine Magnetism Retreat in Santa Teresa, Costa Rica! Applications will be reviewed and you will receive an email within 48 hours.
15
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Please enter a valid phone number.
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4
Where are you from?
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5
What is your Instagram handle?
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6
Why are you interested in joining this retreat?
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7
What type of healing modalities have you tried? (Ex. Mediation, breathwork, energy work)
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8
What are you looking to gain from this retreat?
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9
Tell us a little bit about yourself... (hobbies, daily practices, etc.)
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10
Do you have any dietary restrictions?
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11
Are you able to pay in full or will you need a payment plan ? (Must be payed in full before retreat)
Pay in full
Need payment plan
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12
Did someone refer you ? If so please write who
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13
This retreat will be an investment in time, energy, and growth. Are you ready to fully commit to your transformation?
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14
Are you interested in participating in a psilocybin (mushroom) ceremony?
YES
NO
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15
Is there anything else you would like to share?
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