2025 Bali Retreat Application Form
We will contact you via email regarding the status of your application
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Email *
Full Name: *
What is your best contact phone number? *
What is your date of birth? *
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How did you hear about us? *
Required
Which Retreat would you like to book? *
Required
If selecting The Work In & Work Out Retreat with Cynthia Morton above, please advise current status:
Will you be coming solo, as a duo, in a group? *
Required
If you are part of a group, please list the other people's names below.
Please ensure everyone else submits an application, or skip if not applicable.
What is your relationship with your group/persons?
Skip if not applicable
If no single rooms are available, are you open to sharing a room with a fellow retreater?
 *
We have had attendees share without issue & we take care to match you with someone suitable.  
Due to availability and room configurations we may prioritise applications that are open to sharing.
Required
Have you been to Bali before?
 *
Required
Tell us a little about yourself and your health & fitness over the past 6 months:

 *
What are your intentions for attending a Bali retreat?
 *
Required
What else would you like to get out of attending a Bali retreat? *
What is your greatest challenge at the moment? *
Please be as detailed as possible, so we can ensure this retreat is the right retreat for you.
What do you consider is your greatest strength? *
What do you do for work?  *
Where will you be flying from? *
For example: Brisbane, Australia
Do you have any food allergies, intolerances, or dietary requirements we need to be made aware of?
Skip if not applicable
Are you currently taking any prescribed medication?
Skip if not applicable
Do you have any physical health challenges?
Skip if not applicable
Do you have any specific questions you need answered before committing to a Bali retreat?
Let us know so we can reply with more information.
Any additional questions, queries or comments?
Submit
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