Name
*
First Name
Last Name
Preferred name
Pronouns
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Birthday
*
MM
DD
YYYY
Would you like to be added to our email list?
*
Yes please
No thank you
I'm already on it!
Emergency Contact: Name/Relationship/Phone Number & Email Please:
*
Favorite Color
T-Shirt Size
*
Meditation Experience
*
I have not meditated
I have meditated before but not a lot
I try but do not feel successful
Meditate sometimes
Meditate weekly
Meditate daily
Please check the styles of meditation you have tried:
Yoga Experience
*
I have not tried yoga
I have done yoga a few times
I practiced in the past but haven't for a while
I do yoga once in a while
I do yoga a few times a month
I do yoga once or twice a week
I do yoga three or more times a week
I do yoga daily
I'm a yoga instructor
Please check the styles of yoga you have done in the past:
*
Dietary needs
*
Please check all that apply:
Special dietary needs not already specified:
Would you like coffee on the retreat?
*
Yes, in the morning
Yes, in the afternoon
Yes, in the morning & afternoon
No
What would you like with your coffee?
Please list any food allergies and level of severity:
Please list any other allergies and level of severity:
Please disclose any health concerns we should know about, including but not limited to mental/emotional, breathing/lungs, heart, muscular/joint/bone, or any body systems:
Have you had cacao?
*
Yes, in ceremony
Yes, on my own
What's cacao?
I understand I need a passport to attend this retreat
*
PLEASE READ CAREFULLY BEFORE CHECKING BOX I am aware that any physical activity, including yoga, hiking, traveling, and any other aspect of the retreat includes risks to my physical body, including death, and I agree to hold harmless Erica Onofrio, Soul Dreams Studio LLC., and all other involved individuals, businesses, corporations, and participants for any and all injury, including death, to my person. I understand I am willingly choosing to participate in yoga, meditation, exploring, traveling, boat rides, plane rides, and any and all retreat events at my own risk.
*
PLEASE READ CAREFULLY BEFORE CHECKING BOX I am aware that any physical activity involves the risk of physical injury or death and I agree that I have spoken to my physician about my participation in yoga, meditation, traveling, being on a boat, and all retreat activities, or that I am willingly participating without a physician's consent.
I agree to pay the retreat amount as follows (payment plans or payment in full will be offered):
*
I am aware of the retreat refund policy as follows: 75% of the total amount paid refundable until 1/31/24. 50% of the amount paid refundable until 2/15/25. I understand there are no refunds and no exceptions after 2/16/25. I understand that I am not able to use non-refunded monies towards services or retail provided or sold by Soul Dreams Studio. I understand there are no exceptions to this refund policy.
*
Are you requesting to share a room with someone? If so, who?
PLEASE READ CAREFULLY BEFORE CHECKING BOX I understand that travel outside of the United States carries inherent risk and I agree to hold harmless Erica Onofrio, Soul Dreams Studio LLC., other retreat participants, any businesses, organizations, private owners, tour guides, drivers, or corporations that are part of the retreat from any and all injury, including death, to my person. I agree to willingly travel outside of the United States at my own risk.
*
I understand that this is a sober event and drugs and alcohol are not permitted at any time for the entire duration of the retreat. If I am found with drugs or alcohol I understand that I will be required to leave the retreat immediately and am responsible for my own transportation, food, and lodging moving forward. I understand there are absolutely NO refunds and NO exceptions in this circumstance whatsoever and agree to additional costs I may incur as a result.
*
I understand that all aspects of the retreat are optional and I am able to opt out of any yoga, meditation, journaling, ceremonies, cacao, reiki, excursions, and any and all offerings at any time.
*
What are you looking to achieve from this retreat?
Tell me a little about yourself:
Any additional information you would like to provide:
Electronic Signature: Please Sign & Date
*
First Name
Last Name
Date
*
MM
DD
YYYY
