Illumination of the Five Bodies Retreat
Blissings Tribe,

Thank you for your interest in joining us on this expedition into the nature of the Self at our upcoming retreat in Guatemala. The retreat dates are from Feb. 16 - 26th and will be focused upon the identification, discrimination, activation and re-calibration of the five body sheaths we commonly assume as our identity rather than the personal and impersonal Atman (Self) or SuperSoul of infinite Consciousness.

Further and more complete details of everything we will be learning, experiencing and teaching on the retreat can be found at along with information regarding accommodation/amenities and hospitality. Before filling out this application please be sure you have somewhat of an understanding of what this retreat will entail and make an inner commitment to yourself and your healing journey/consciousness expansion to attend this transformational experience. Once you have applied and we have reviewed your application, if accepted you will be asked to administer a non-refundable deposit of fifty percent of the total retreat expenditure of $1555 ($777.5) to lock in your attendance, the remaining balance is due at the latest 3 weeks before the retreat begins on Jan. 26th, you have the option to pay in full as well, which will automatically cover your deposit. Acceptance and declinations and answers to your questions will be sent to the email you provide for us in this form with a subject of: "Live Your Dharma" in the title as soon as possible.

To apply for our retreat we ask that you answer the following questionnaire to the best of your ability:

Email address *
First - Middle - Last Name: *
Your answer
Date of Birth (MM/DD/YY) *
Your answer
Street Address for Your Home Residence: *
Your answer
Country - City - State - Zip code: *
Your answer
Best Phone Number: *
Your answer
How did you hear about this retreat? *
Your answer
If you heard of us through Instagram, what's your IG username? *
Your answer
Have you ever been convicted of or pleaded no contest to a crime? *
If yes, please explain the number of conviction(s), nature of offense(s), leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation:
Your answer
Have you ever been accused of, convicted of, or pleaded no contest to sexual harassment or sexual abuse? *
If yes, please explain the number of times, nature of offense(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation:
Your answer
Do you have any dietary restrictions that we should be aware of?
Your answer
Are you currently taking any medications? *
If so, for what condition(s) and for how long?
Your answer
Have you ever received treatment for mental illness? *
There will be no use of alcohol, drugs, or cigarettes, on the retreat can you commit to not using these substances during this time? *
Do you have any questions that are not answered on the website/retreat description?
Your answer
I certify that the information in this application is true and complete: *
I certify I have read and agree to the liability waiver below: *
The participant agrees that attending Live Your Dharma: Illumination of the Five Bodies (hereinafter referred to as
“Live Your Dharma”) is entirely at his/her/their own risk. Any experience or services are
provided "as is," without warranty of any kind, either expressed or implied, including without
limitation any warranty for information services, coaching, uninterrupted access, or products and
services provided through or in connection with the service. The participant acknowledges and
agrees to the following:

- The participant agrees that the use of all, or part, of the service is entirely at the
participant's own risk. Any actions or lack of actions, taken by the participant of such
advice is done so solely by choice and responsibility of the participant and is neither the
responsibility nor liability of event organizers/facilitators, their agents, employees,
officers, volunteers, and/or contractors, and any person or organization associated with
them and their activities (collectively known as “Conscious Collective”).

- The participant understands that any experience, service and/or information at the event
is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or
substance abuse treatment, and the participant will not use it in place of any form of

- The participant recognizes that the group processes on the event require emotional,
physical, and mental efforts, exertion, and behavioral experimentation, on the participant's
part, which may cause physical, mental or emotional stress. The participant fully
acknowledges and takes full responsibility for all risks involved.

- The participant understands that it is his/her/their responsibility to consult with his primary health
care provider prior to participating and should the participant choose not to consult his/her/their
health care provider, the participant accepts full responsibility waiving all rights to liability
or any claims against Live Your Dharma (Conscious Collective) and any of its agents, administrators, or employees.

- The participant attests to the fact that the participant has, or will prior to arrival, disclosed
all relevant information regarding his/her/their physical, emotional or mental conditions that could
cause harm to the participant by participating in this training.

- The participant, and/or legal representatives forever release, waive, discharge and
covenant not to sue Live Your Dharma (Conscious Collective) for any injury, harm or death caused by either negligence
or other acts.

- The participant has read and understood this form and all its contents, and the participant
voluntarily agrees to the terms and conditions stated above inherently by submitting this application.

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