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Awaken Women Retreat
ADVANCE LEVEL / APPLICATION
19
Questions
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1
Your Full Name
*
This field is required.
First Name
Last Name
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2
Your Email
*
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example@example.com
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3
Phone Number
*
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With Country Code
Please enter a valid phone number.
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4
Your date of birth
*
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-
Date
Year
Month
Day
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5
What is your Instagram? (optional)
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6
Have you joined our previous Woman Retreat before?
*
This field is required.
YES
NO
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7
If yes, which one? (UK, Portugal, Bali)
*
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8
If no, have ever done a Women’s Retreat before? Please share details.
*
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9
Have you done any therapy, bodywork or other self-development practices?
*
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YES
NO
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10
If yes, please describe exactly.
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11
Have you done Breathwork before ?
*
This field is required.
Referring to Conscious Connected Breathwork / Transformational-Style Breathwork.
YES
NO
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12
Do you have any food allergies?
*
This field is required.
If yes, please provide details.
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13
Do you have any pre-existing medical conditions?
*
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If yes, please provide details.
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14
Are you currently pregnant?
*
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If yes, please provide details.
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15
What is your main intention for joining Awakened Woman Advanced Level?
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16
Is there anything else you would like us to know about you?
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17
Which room option would you like to book for the retreat?
Private Room / Early Bird (£1750)
Shared Room / Early Bird (£1550)
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18
Which payment plan would you like to select?
Abundance → Full payment
Harmony → 2 payments
Flow → 3 payments
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19
If you are booking with a friend, please provide their name so we can try to accommodate you together.
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