Costa Rica - Wellness Vacay Registration Form

This is a perfect opportunity individuals who prefer intimate settings over large groups, and those craving a more personalized experience. It's for the ones who give endlessly to others and now seek someone to pour into them. This is a Girls Trip Style - Wellness Vacay with a dash of "turn-up" aka a touch of action to complement their rejuvenation.

Our retreat is designed for a small, close-knit group of 6-8 women who will share this carefully crafted experience together.

This is not just a retreat; it's an invitation to let Costa Rica unfold its magic on your journey of self-fulfillment.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Social Media
(Optional: LinkedIn/ Instagram / Facebook/Website )
How did you learn about this Wellness Vacation?*

Word of MouthFacebook / InstagramQueen By Nature WellnessChandra AieshaTheressia NangleOther
What's inspiring you to take a Wellness Vacay? What do you wish to receive from this Wellness experience?*
Dietary*

No RestrictionsGluten-FreePlant Based / VeganOther
Will this be your first out of country experience?

YesNo
Do you need assistance coordinating a flight that aligns?*

YesNoOther
Will this be your first retreat?

YesNo
Do you have any health limitations or physical injuries? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma,diabetes, seizures, osteoporosis,difficulty walking, mental health concerns, etc.)*
What is your experience with Yoga, and/or Meditation?*
Are you bothered by scents (essential oils, incense, perfumes etc.)? If yes, please let us know the details.*
What is your level of comfort when it comes to getting into the water? (pool/ocean/lagoon/river/waterfall)*
Room Booking Style Interested in:*

$2400 - Shared Room - Bunk Bed$2500 - Shared Room - Queen Bed$2900 - Private Bedroom - King Bed
How would you like to invest in your Wellness Retreat Experience?

Pay in FullAffirm - Credit Financing OptionHold space with $500 Deposit and make payments (final payment due by June 21,2024)
Is there anything additional that you would like to share about yourself?
OPTIONAL
What size shirt do you wear?
Complimentary Retreat Souvenir Shirt Data
Vibe Check | Phone Call (We'd like to connect with you)
Check your email for all future updates.

Wellness Vacay Group photo from our April 2022 Tulum Retreat

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