Registration Form: Phoenix Retreat

Registration Form

Phoenix Retreat • 28 June - 04 July 2025 (7D6N)
Service Status

Offer sentUnable to offer, reason
Your Retreat Experience
We’re excited to have you join us at the Phoenix Retreat! For more details about our activities, accommodations, and what to expect, please visit our landing page via the link below. If you're ready to register, fill out this form - we can't wait to meet you!

DISCOVER MORE ABOUT PHOENIX RETREAT
Contact Information
Referral Code
Email*
example@example.com
WhatsApp Number
Please include country code (e.g. +65 91234567)
Profession/ Designation*
Please describe your profession/ designation*
Company Name*
Write NA if Not Applicable
Business Social Media Account*

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Please let us know your social media handle(s)*
e.g. instagram @simalemsanctuary
Retreat Registration

This form allows registration for maximum 8 participants. Please submit another form for the 9th participant onwards.

Participant's Details

	Full Name	Age	Gender	Program Choice	Preferred Occupancy	Email Address (for separate confirmation/ billing)	WhatsApp Contact Number (please include country code)
Participant 1
Participant 2
Participant 3
Participant 4
Participant 5
Participant 6
Participant 7
Participant 8

Important
- Please note that all our rooms are assigned on Run-Of-House basis, meaning you will be assigned the best available room upon check-in.
- 2-way group transfer between Kuala Namu International Airport (KNO) and Taman Simalem resort is included in the package price. The transfer is tentatively scheduled as departing KNO on 28 June 2025 at 10.30am and departing Taman Simalem resort at 12noon on 04 July 2025. Private transfers can be arranged at an additional cost.
- Our resort's unique layout and natural surroundings mean that all rooms and villas are accessible by staircase. We hope you'll enjoy the scenic views and tranquil atmosphere that come with it. Unfortunately due to the design of the accommodation and facilities, we are not able to cater for people with disabilities.
- Please also be informed that all activities, workshops, and sessions during the Phoenix Retreat will be conducted solely in English. Participants should have a basic understanding of the language to fully engage in the experience.
Reminder: When booking a twin/ triple sharing rate, please make sure to provide all two/ three names. If not, you might be sharing with a new friend! Just a heads up that we can't guarantee roommate preferences or changes to room assignments.
Health Concerns / Special Requests / Preferences
Please let us know – Do any of the above participants have any specific preferences or needs such as dietary restrictions, medical condition, accessibility requirements?. Please indicate as follows: eg. Participant 1 - Anna is on high blood pressure medication and wears prosthetics on left leg.
Important Notes for INDUSTRY PARNERS
1. Registration is not confirmation: Registration of interest is not a confirmation of space. We will revert with confirmation based on availability.
2. Eligibility: The industry rate discount is exclusively offered to bona fide wellness business owners, retreat facilitators, resellers, and travel media correspondents who are interested in reviewing our facilities and retreat offerings.
3. Participation limit: We will limit participation from the same institution to a maximum of 2 persons. Priority will be given to those who have experience in organizing retreats/wellness activities.
4. Verification: We may require valid documentation or proof of your profession/business upon request to verify eligibility for the industry rate discount.
5. Payment terms: Once space is offered, full payment of the nett retreat package price will be required within 3 days. We reserve the right to offer the space to others if payment is not received by the deadline.
6. Payment policy: For industry discounted rates, payment made is non-refundable. Transfer to another eligible person is permitted subject to approval from management.
7. By registering your interest, you acknowledge that you have read, understood, and agreed to the terms above.
Preferred Correspondence and Billing Notice*
Please let us know how you want us to confirm your retreat space and issue your invoice
Please advise how you want us to correspond and issue bill for all the above participants*
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