Clone of Costa Rica 2026 Registration Form

  • Costa Rica Retreat

    Back to Center 

    January 10 - 16, 2027

     

     

     

  • Registration Form

    Fill out the form carefully for registration
  •  -
  • Will you be attending as a module 1 student?

  • This experience can be taken as a retreat (participate in what feels right for you) or as Module 1 Training. If you choose the training track, full attendance is required for all training hours over the 6 days.

  • How did you hear about this retreat?

  • Browse Files
    Cancelof

  • *NOTE*

    Prices for Costa Rica Retreats are in US DOLLARS. You will receive an email immediately following registration, please check your junk mail if you do not see it. Your receipt will be in that email. Non Refundable if cancelled less than 45 days before the date of trip.

  • My Products

    prevnext( X )
    Jan 10 - 16 - Back to Center - Private Room . January 10 - 16, 2027 Private room, king bed, private bathroom. 6 Nights, 7 Days, Somatic Retreat/Training, Excursion, Shuttle from San Jose to Casa Firefly, ALL Meals Included.

    Jan 10 - 16 - Back to Center - Shared Room . January 10 - 16, 2026 Shared room (roomate or partner/spouse) can be set up with a king bed or 2 singles, private bathroom. 6 nights, 7 days, Somatic Retreat/Training, Excursion, Shuttle from San Jose to Casa Firefly, ALL Meals Included. (spouses must register seperately)



    BOGO Shared Room . January 10 - 16, 2026 Shared room (roomate or partner/spouse) can be set up with a king bed or 2 singles, private bathroom. 6 nights, 7 days, Somatic Retreat/Training, Excursion, Shuttle from San Jose to Casa Firefly, ALL Meals Included. (spouses must register seperately)




    Total $0.00$0.00

  • Photograph and Video Release Form

    I grant Nikki Semeniuk & Serenity Somatics permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears.

    Photographic, audio or video recordings may be used for the following purposes:

    Conference presentations
    Websites
    Informational presentations
    Social Media
    Educational videos
    By signing this release, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting.

    I will be consulted about the use of the photographs or video recording for any purpose other than those listed above.

    There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. 

    This release applies to photographic, audio or video recordings collected, video clips and image, online, and Social Media channels as part of the sessions listed on this document only. 

    Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

    By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

  • Payment Methods

    Choose from one of the PayPal options to make your payment.

    Buy with
    Buy with
  • Should be Empty: