Retreat Application FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *What are you hoping to gain from joining a retreat? *Please explain your current healthcare regimen. What are you doing or taking to support your physical, mental, spiritual, and emotional health? * are EMF stopping How open are you to reducing toxicity in your environment and lifestyle? For example, eliminating processed foods and sugars, reducing alcohol intake, stopping smoking, reducing chemical additives in body and home products, and taking measures to protect yourself from unnecessary EMF (electromagnetic field) exposures? *Any dietary requirements, allergies, or sensitivities to consider? Are your reactions severe? *Desired retreat location(s) *Costa RicaEuropeUnited StatesYour HomeDesired Year(s): *20252026Desired Month(s): *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctober (No dates for Costa Rica during Monsoon Month)NovemberDecemberRetreat Preferences *Group RetreatsIndividual or Private Retreats (Customized for yourself or group)Pre-Retreat MentorshipLong Term Costa Rica StayRoom preference: *Do you have any special requests or questions for us? *Submit
