Bali Retreat Application

We would love to get to know you better! Please take a moment to complete the short questionnaire below. Once your application has been accepted, there will be a $500 deposit to secure your spot.

Name *
Name
Note: No prior experience is necessary
If yes, please share more about your experience(s).
Please include any physical conditions, injuries / limitations, history of mental illness, medications currently being taken, etc.
If so, please enter their name(s) below or note "single".
If you were referred by a friend, please share their name so we can send them some love!