Lasry Academy – Retreat Registration

Lasry Academy – Retreat Registration

Register now for our transformative retreat experience. Please fill out the details below to secure your spot.
Full Name**

First NameLast Name
Email Address**
example@example.com
Mobile Number (with WhatsApp)**
Please enter a valid phone number.
Country + City**

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
Date
Gender (Male / Female / Other)

MaleFemaleOther
Which retreat are you registering for?*
Please specify other retreat
Need help with accommodation?

YesNo
Coming alone or with someone?*

AloneWith someone – please specify name
Please specify name if coming with someone
Any dietary restrictions or medical needs?
What are you hoping to gain from this retreat?*
What is your current focus in life?*
Please specify other focus in life
Preferred payment option*

Single paymentTwo installmentsSpeak with me first
I understand this is an immersive, transformational experience requiring full participation*

I understand this is an immersive, transformational experience requiring full participation
I agree to the retreat terms & refund policy*

I agree to the retreat terms & refund policy
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