Retreat Waitlist
Registration
Confirm Retreat Style
*
Healing Journey
Girls' Trip
Desired Travel Month
April 2025
August 2025
September 2025
December 2025
Name
*
First Name
Last Name
Birth Date (Optional)
Please select a month
January
February
March
April
May
June
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August
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October
November
December
Month
Please select a day
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Day
Please select a year
2024
2023
2022
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Year
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Social Media
(Optional: LinkedIn/ Instagram / Facebook/Website )
Dietary Needs to support Wellness Vacay Experience
*
No Restrictions
Gluten-Free
Plant Based / Vegan
Other
How did you learn about this Wellness Vacation?
Word of Mouth
Instagram
Facebook
Queen By Nature Wellness
Other
What do you wish to achieve from your Wellness Vacay Experience, What are your goals, and/or expectations?
*
What is your level of comfort when it comes to getting into the water? (pool/ocean/lagoon/river/cenote)
*
Do you have any health limitations or physical injuries? Trouble walking? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma, diabetes, seizures, osteoporosis, mental health concerns, etc.)
*
Are you bothered by scents (essential oils, incense, perfumes etc.)? If yes, please let us know the details.
*
Do you have any Questions or would you like to elaborate on the retreat experience you would like curated?
(optional)
Submit
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