EXPLORE RETREAT 2020 - Registration Form
Exploring our inner and outer worlds through yoga, breathwork and adventure !
October 18-24, 2020 - Puerto Viejo, Costa Rica
Your Guides: Cathy Cannon and Kylie Judge
THANK YOU FOR JOINING US!
Sign in to Google to save your progress. Learn more
Email *
Full Name (As shown on Passport) / Contact Information (address, phone, etc.) *
Passport Issue Date *
MM
/
DD
/
YYYY
Passport Expiry Date *
MM
/
DD
/
YYYY
Do you go by a name that is different than what is on your passport ? *
Date of Birth *
MM
/
DD
/
YYYY
Emergency Contact (Name, Relationship and Contact Information) *
Have you purchased a flight ? If yes, please indicate Flight Details (Airline, Number, Arrival and Departure Dates and Times) *
We require participants to have travel insurance. Please list the Company you have coverage with, relevant policy numbers and contact information. *
Will you be taking the provided shuttle from the airport on October 18th, 2020. If no, please indicate how and when you will be arriving in Puerto Viejo. *
Do you have any medical conditions and/or take regular medication ? *
Do you have any allergies ? *
Do you have any dietary preferences and requests ? (There will often be a seafood option at meals, please indicate if you would prefer the seafood, vegetarian, vegan, Gluten-Free, or meat options) ** Please note that we will submit this info to the food and beverage staff and they will prepare food based on these preferences so it is important you stick with your requests!) *
Room Requests - please indicate if you have chosen shared double, private single or private couple and list anyone your are traveling with and if you would like to share a room with them. *
We require a 25% deposit at the time of registration to hold your spot, deposits are non-refundable. *
Explorations - there are lots of things to do in your free time, including just relaxing and BEING. Please let us know your interests and priorities. *
Required
Have you experienced conscious connected breathwork before ? If yes, please share a little about your experience. *
We are excited that you have chosen to EXPLORE with us! Please tell us a little bit about yourself, your intentions and why you have decided to join us ! *
Anything else we need to know ? *
PLEASE SHARE YOUR FLIGHT DETAILS AND TRAVEL PLANS WITH US HERE IF YOU HAVE BOOKED. If you have not yet booked, just let us know what you are considering, as we will send another email out closer to the date as well confirming travel plans. ** A gentle reminder that the shuttle transportation that is included in your retreat investment will be leaving the SJO airport at appx. 1:00pm on October 18th, 2020 and departing Puerto Viejo for San Jose mid-day on October 24th, 2020. This shuttle ride takes roughly 4.5 hours. Please choose your flights accordingly or fly in a day prior so that you that you can be on-time and catch your ride in each direction ! We are here to support you with creating your travel plan - let us know if you have any further questions. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy