Welcome to The Wild Within Your Journey Begins Here Thank you for your interest in joining us in Costa Rica. We're excited to learn more about you as we prepare for a week of cacao, nature, adventure, authentic self-expression, joyful connection, and renewal in the rainforest.
The Wild Within A Journey of Joy, Connection & Renewal
November 4-11 2026 Cabanga,Costa Rica
Guest Information
Name
First Name
Last Name
Birthdate
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Month
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Day
Year
Date
Gender
Male
Female
Other
Email
example@example.com
Cell Number/WhatsApp if not in USA
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Information
Emergency Contact's Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Have you participated in a Adventure/Yoga/Meditation/Spiritual Retreat Before?
Please Select
Yes
No
What inspired you to apply for The Wild Within at this point in your life?(There's no right or wrong answer—we simply love hearing what called you here.)
Which of the following experiences have been part of your journey? (Select all that apply.)There are no right or wrong answers, and no experience is required. We simply love getting to know everyone joining us. While this isn't a yoga retreat, we'll offer a variety of optional practices throughout the week to support relaxation, presence, connection, and authentic self-expression.
Meditation
Yoga
Tai Chi/Qi gong
Dance or other conscious movement practices
Energy Healing
Plant Medicine Ceremony
Sound Healing/Vocal Toning
Breath Work
Therapy or Coaching
None of the above but I am ready to explore something new!
other: please explain
Is there anything you'd like us to know about your health, mobility, or physical comfort that may affect your participation in any retreat activities? Our retreat is designed to be welcoming to a variety of abilities, and all practices—including movement, breathwork, and hikes—are always optional. We encourage everyone to listen to their own body and participate at a pace that feels supportive. During activities like our waterfall hikes, there is plenty of opportunity to rest, take your time, and simply enjoy the beauty of the rainforest.If yes, please share anything that would help us better support your experience:
Do you have any special dietary requirements? Meals can accommodate vegan, vegetarian dietary restrictions. We'd love to hear your eating preferences!
Do you have a current passport?
yes
no
Let's jump on a call to connect, is there anything specific you'd like to know?
Do you plan to join solo or with a friend?
With a friend and we'd like to room together
Solo, please pair me with a new friend!
I would like to join with my family for another date! If this is your selection please let us know what date you are called to: JAN/FEB 2027 NOV 2027
Accommodation request-all rooms are shared with a private bathroom & balcony
Queen Bed $3,500
Single Bed Bunk $3,000 *limited availability
Retreat Guidelines & Acknowledgement To help create a safe, welcoming, and meaningful experience for everyone, we ask that you review and agree to the following: ~Presence & Community This is an alcohol- and drug-free retreat. We invite everyone to arrive with an open heart, be fully present, and contribute to a supportive community throughout the week. ~Mindful Technology To help us immerse ourselves in nature and connect with one another, we encourage phone use only for photos and essential communication. ~Participation No prior experience with yoga, meditation, movement, or breathwork is required. All activities are optional, and we encourage you to honor your body and participate at a pace that feels right for you. ~Health & Personal Responsibility By participating, you acknowledge that you are responsible for your own health and well-being and that you are physically and medically able to participate in retreat activities. You agree to listen to your body, make choices that feel appropriate for you, and communicate any health concerns, injuries, allergies, or accessibility needs with the retreat facilitators before and during the retreat. ~Reservations & Payments Spaces are limited and reserved on a first-come, first-served basis. Your space is confirmed once payment has been received. All retreat payments are non-refundable. We strongly recommend purchasing travel insurance to protect your investment in the event of illness, travel delays, emergencies, or other unforeseen circumstances. ~ Itinerary Costa Rica has a rhythm of its own. Weather, wildlife, road conditions, or other circumstances may occasionally require adjustments to the itinerary. If changes are needed, they will always be made with your safety and the overall retreat experience in mind. ~Optional Experiences You acknowledge that you have reviewed what is included in your retreat package. Optional activities, such as massages, horseback riding, or zip-lining, are available at an additional cost and may be arranged separately. Thank you for helping us create a joyful, respectful, and connected experience for everyone. We can't wait to welcome you to Costa Rica.
I have read and agree to the Retreat Guidelines & Acknowledgement.
I understand that participation in all activities is voluntary, and I am responsible for participating at a level that feels appropriate for me.
I understand that retreat payments are non-refundable and that travel insurance is strongly recommended.
I Disagree
Signature
Date Signed
-
Month
-
Day
Year
Date
What payment option are you interested in? $500 deposit reserves your spot and from there payment plans maybe set up. All payments are due on the first of the month with the balance due by February 1st, 2026
I would like to pay in full one time
I would like to pay for Renewal of Spirit in 2 Payments
I would like to pay for Renewal of Spirit in 3 payments
I would like to pay for Renewal of Spirit in 4 payments
You understand what is included in the cost of the retreat and are excited/ready to make your $500 nonrefundable deposit to secure your spot?
yes, I'm in!
no
Not yet, I have questions
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