Breathe in Bali• Application• Sept 16-22 , 2018
Let us know more about you! (PLEASE NOTE you'll also need to submit deposit to hold your spot for the retreat!)
Your Full Name
What are you looking to achieve by coming on this retreat? (What's your intention?)
What type of work / lifestyle are you involved in?
Will you require any special assistance (physically or otherwise)?
Do you plan to come alone or as a couple?
I'm planning to come alone and would like my own private room.
I'm planning to come with a friend and would like to share a room with two twin beds.
I'm planning to come with my partner/spouse and would like a king bed to share.
I'm planning to come alone but I'd like to share a room with someone (please pair me!)
What's the best time to reach you?
A copy of your responses will be emailed to the address you provided.
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