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Basic Info
Contact Info
First & Last Name
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Email
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Phone
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Emergency Contact
First & Last Name
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Phone
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Health & Safety
Food allergies or dietary restrictions?
Medical conditions or injuries?
Do you currently take any medications we should be aware of?
Which best describes your diet?
No Preference
Pescatarian
Vegetarian
Vegan
Gluten-Free
Other
Retreat Preparation
What inspired you to join the Art of Healing Retreat?
Which area(s) of your life are you currently seeking healing in? (check all that apply)
Emotional Healing
Physical Healing
Spiritual Growth
Stress Relief & Relaxation
Clarity & Direction
Creativity & Expression
Other
How new are you to yoga?
Brand New (this will be my first time)
Beginner (I’ve tried a few classes, still learning)
Intermediate (I practice somewhat regularly)
Advanced (I've completed hours of training and certification)
How familiar are you with meditation?
Brand New (I’ve never meditated before)
Beginner (I’ve tried short guided meditations)
Intermediate (I meditate occasionally on my own)
Advanced (I have a regular meditation practice)
Are you open to sharing during group circles?
Yes
No
Maybe, depending on the moment
Which creative/healing activities are you most excited about?
Journaling
DIY Yoga Flow
Herbal Tea Workshop
Natural Perfumery
Cooking Class
Shadow Work Circles
Are you interested in reserving any add-on sessions during your free time? (Check all that apply)
Private Yoga Session (personalized to my needs)
1:1 Nutritional Consultation (must complete additional intake prior to stay)
Jungle Mama Pop-Up Shop
Services
Select a service
Please share anything else you’d like us to know to make your retreat experience most supportive.
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