Body Intelligence Retreat Form
Please take a moment to fill up this Retreat Form. We take your privacy very seriously. Your personally information is strictly confidential.
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Full Name *
Birth Date *
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DD
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Gender *
Email address *
Phone Number *
Single/double occupancy *
We only recommend double occupancy if you are attending the retreat with a partner. Otherwise, we recommend that participants stay alone overnight as this is very much part of the mindful detox process)
If attending with a partner, please provide their name and age
Food allergies if any
Have you practiced yoga before? *
Please describe your practice (how long have you practiced yoga, how often, and what type of yoga do you practice) *
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Have you experienced any of these conditions? (Check all that apply) *
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Medication that you are currently taking and conditions they are related to *
Any other health concerns we should know about?
Other comments that may be important for us to know
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