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Nourished to Bloom Retreat, June 2025
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Date:
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Full Name
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E-Mail Address
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Phone Number (including country code):
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What is your preferred way of communication ( email / WhatsApp / phone text / Instagram )?
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Date of birth
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Full Address:
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Are you traveling with another person? If so who?
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What packages are you interested in?
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SHARED: BUNK
SHARED: SINGLE BEDS
SHARED: DOUBLE BED
PRIVATE DOUBLE BED
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Are you interested in a 1:1 session slot with Lena at the retreat?
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Yes - I am curious to learn more about it.
No - I am happy with the current package.
Are you interested in a payment plan?
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MAYBE
Can we contact you to set up a consultation call?
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What are your goals/ intentions going into this retreat?
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What do you believe has been holding you back from reaching your goals until now?
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Have you been to a retreat before?
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Other:
Mental Health Conditions we need to be mindful of?
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Do you have any medical conditions/health concerns/allergies or injuries that we should be aware of?
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Diet Preference
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How did you hear about us?
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