TUSCANY registration form:

Step #1: Fill out the registration form:

(After submitting application you can pay a deposit, and I will reach out to confirm!)I respect your privacy. This information will stay confidential, only I will be seeing this and this information is used for the purpose of helping applicants gain the most benefit for them out of this retreat experience.
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Gender
Preferred Pronouns
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
In a few short sentences, tell me about yourself
How often do you practice yoga? (Beginners welcome! We just want to know about your background to make this experience for YOU!)

Occassionally1-2 times a week3-4 times a weekDailyNever taken a yoga class
How often do you practice Pranayama (Breathwork)? (Beginners welcome! We just want to know about your background to make this experience for YOU!)

Occassionally1-2 times a week3-4 times a weekDailyNever
How often do you practice meditation? (Beginners welcome! We just want to know about your background to make this experience for YOU!)

Occassionaly1-2 times a week3-4 times a weekDailyNever
If you practice yoga, what type of class do you usually attend or style do you practice (ex. flow, hatha, yin, ashtanga, kundalini, etc.) *N/A if you don't practice yoga.
What are your wellness, health, physical and/or soulful goals ?
Have you joined an international yoga retreat before? If yes, where and when?
Why would you like to join my Tuscany retreat?
What would you like to receive from this retreat?
What would you like to comeback with from this experience?
What are you most excited for on this retreat?
Do you have any physical or health limitations/conditions or injuries I should know about? (i.e heart, blood pressure, depression, anxiety) or any health concerns that you feel may affect your yoga retreat experience:
Are you on any medications?
Is there anything that you may need for accommodation or accessibility?
Any allergies or dietary restrictions?
I have read and acknowledge that on this retreat there will be optional alcohol consumption and that if i choose to participate, I will be responsible, as well as respectful to others in the retreat, the leader and those housing us/around us. If there is inappropriate behaviour, I can be prohibited from drinking the remainder of the retreat in order to continue to participate.

Yes
I am interested in the following room(s) **Please note that room availability is on a first come first serve basis.

Private Occupancy (Waitlist option)Shared Occupancy (2 beds)Shared Occupancy (3 beds)
Name of friend(s) you want to be placed with in room (if registering with someone) Please put need placement if alone.
Which form of payment are you interested in?

I will pay all at onceDeposit + a final payment before March 31st, 2025Deposit + 2 scheduled payment installmentsI need to discuss an alternative payment plan
How did you find out about this retreat?
Anything else you feel I should know?
Date

MonthDayYear
Date
Signature

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NEXT STEPS:

I am so excited for you to join me in Tuscany! Once you submit this form, you can reserve your spot by completing a deposit at the link below this application or request from me the payment link to pay in full. I will be in touch with you soon to secure & confirm the room/bed you are interested in and to send you all details and next steps.

The magic of Tuscany awaits!!
Should be Empty:

Step #1: Fill out the registration form: