Portugal Retreat Registration form
We are so excited that you want to join us on this retreat at Terra Quinta, Portugal. 
Please register the form below, to reserve your spot!
Sign in to Google to save your progress. Learn more
Terra Quinta

Retreat days: 16 - 20 October 2024
Retreat Adress: Rua dos Zambujeiros, Santo Estevao, Benavente, Santarem, 2130-130 Portugal
Contact: Roshi on info@roshiderakshan, Rosanna on info@flowbreathworkstudio.com
First and Last name *
How old are you? *
Email and Contact number *
We will organise a group whatsapp group before the retreat, to syncronise travels etc. Is this ok with you, or do you want to opt out? *
How did you find out about our retreat :) *
Please let us know if you have attended any retreats in the past, or have any experience with personal development, breathwork or meditation.
(No previous experience is required for this retreat)
*
Dietary restrictions: *
Do you have any mental health or physical health symptoms/ medication that we should be aware of? Please let us know.
(Heart condition, asthma, allergies, epilepsy, anxiety, depression)
*
I understand that I will have to pay the deposit upon registration
*
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy