Event registration
Event Timing: October 12th - 18th, 2022
Event Address: Desa Saya Eco Luxury Resort & Spa
Contact us at 07565 619104 or lis@liscashin.com

PLEASE COMPLETE THIS FORM. All your answers will be kept confidential and not shared with anyone else. We ask these questions to understand you and your needs better and so that we can best support you on the retreat - to have a fun, safe and enjoyable experience and to get the most out of your time with us. If you are uncomfortable answering any of the questions just let us know. Many thanks in advance. Lis
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Email *
What are your first and last names? *
What would you like us to call you? *
What is your email address? *
What is your mobile phone number? (with country dialling code) *
What country are you flying from? *
Are you over 18? *
Do you identify as female? *
Select which statement applies best to you *
Required
If you could create your dream life with no limitations, what would you be doing? *
Tell us a little bit about yourself - e.g. what passions/interests do you have? Fun facts about yourself. What makes you YOU? *
How would you describe yourself in 3 words? *
What is your greatest strength? *
What is your greatest limitation? *
If you could change anything about yourself or your life, what would that be? *
What is your reason(s) for coming on the Coming Home to Your Heart retreat? *
Have you done any courses/workshops/retreats with Lis Cashin or Lia Unguwan before? *
What are your expectations for the retreat? What would you like to leave with? How do you want to feel at the end? *
Are you coming on your own or with someone else? If yes, then what is their name(s). Do you want to share a room? *
Are you open to sharing a room with someone you don't know? *
Do you have any physical health challenges or disabilities that we need to be aware of to support you on the retreat? What adjustments can we make for you? *
Are you currently or have you in the past suffered from any form of mental health challenges or disability? If yes, do you feel mentally ready to come on the retreat? Are you currently taking medication or attending therapy? How can we support you best on the retreat? What adjustments can we make for you? *
Are you currently taking any prescribed medication? If yes, please give details *
Do you have or have you ever experienced sleep walking, snoring, insomnia, or any other sleep disturbances? If yes, please give details *
Do you have any phobias? If yes, please give details *
Have you ever been to Bali before? *
What is the most EMPOWERING song that you love? The song that makes you feel like the incredible woman you are! *
Dietary restrictions *
Is there anything else you want to tell us or feel we need to know before you come on the retreat with us? *
I understand that I will have to pay my 25% deposit in order to secure my place on the retreat *
Required
I understand that in order to ensure the safety of everyone on the retreat, you may need to contact me based on my answers to the questions above. You are inclusive and will do everything you can to ensure I can attend the retreat, but it may be that you need to ask for additional medical approval if I have physical or mental health disabilities. This is to ensure that the retreat is going to be the right experience for me. I understand that the retreat is not therapy and that if I feel triggered I will seek therapeutic support outside of the retreat at my own expense. *
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