R E T R E A T

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Name
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Name* This field is required.
Name
Surname
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Email* This field is required.
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Phone Number:* This field is required.
(+XXX) XXX XXX XXX
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Current Ocupation* This field is required.
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Date of Birth* This field is required.
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Your goals:* This field is required.
Relax/Stress reduction
Increase energy levels
Focus & Productivity
Detox
Lose weight
Reconnect
Self-knowledge
Learn about Breathwork
Practice Yoga
Do the ice bath
Learn about Longevity & Wellness
Improve Mental Health
Overall physical & mental health
Other
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Yoga Level:* This field is required.
Never tried
Beginner
Intermediate
Advanced
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Health issues or injuries? Please specify
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Select the options that apply to you:* This field is required.
Cardiovascular Issues
Epilepsy
Pregnancy
Breastfeeding
Respiratory issues
I declare that I do not have any of the conditions above.
Other
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Food allergies or restrictions? Please specify
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REGISTRATION INCLUDES: ACCOMMODATION + MEALS + ACTIVITIES* This field is required. PAYMENT TO IBAN: LT063250017444387035 BIC/SWIFT: REVOLT21 Beneficiary: Sofia Ribeiro
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Order Summary
Total PriceEUR
EARLY BIRD EXCLUSIVE PRICE - 1 spot in 2 people lodgeACCOMMODATION + MEALS + ACTIVITIES
€420.00Edit
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What other ESSE MOOD services you might be interested in?
Retreats
Workshops
Teambuildings
Wellness Coaching
Monthly Wellness Memberships
Online Workout/Yoga classes
Other
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How did you heard of us?* This field is required.
Word of mouth (family, friends,...)
Google
Instagram
Through Sofia
Other
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Terms and conditions:* This field is required.Registration and Payment: Registration for the Retreat is only considered effective upon the full payment of the fee. Participants can make payments via bank transfer or cash. Payment details are above and will also be provided via email after filling out this form. Individual Responsibility: Each participant is responsible for their own safety during the retreat. ESSE MOOD is not liable for injuries, damages, or loss of personal property during the retreat. Changes and Cancellations: ESSE MOOD reserves the right to change dates, times, or cancel the retreat for unforeseen reasons. Participants will be notified in advance, and fees paid will be fully refunded in case of cancellation. Refund Policy: Cancellations made by participants with a notice period of 5 days will receive a full refund. There will be no refund for cancellations made less than 5 days before the start of the retreat. Disclosure of Other Events: The provided email address may be used to send information about future events, campaigns, and activities related to ESSE MOOD. Photographic and Audiovisual Record: By participating, registrants agree that images and videos captured during the retreat may be used by ESSE MOOD for promotional purposes. Privacy and Security: The email address and personal information provided in this form will be kept confidential and will not be shared with third parties without your consent.
I have read and agree to the above terms and conditions
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