Retreat to the Islands of Thailand with Peace Inside Live

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Retreat to the Islands of Thailand with Peace Inside Live - Application Form

Namaste and welcome - this form is for those who are interested in attending the Peace Inside Live Retreat to Thailand, scheduled for May 23 - May 31, 2022. We use this form to get to know each other and to make sure this retreat will be one that excites your heart!

Explore the islands of Koh Samui and Koh Phangan with expert guide and local, Jordana Reim, while living into the infinite possibilities of your life. This retreat is designed for restoration at a soul-level, while also inspiring creativity, mind-shifting perspective and exploration.

WHAT’S INCLUDED:

Luxury hotel accommodations with spectacular views of the sea
Brunch & Dinner tailored to your food preference (with the exclusion of meals or extras during free time)
Private day trip & sailing journey in the Gulf of Thailand
Boat transportation from Koh Samui to Koh Phangan
Private vehicle transportation to all group activities
Optional visit to Elephant Sanctuary
National park entry fees
Arrival gift package & 60-minute massage/healing session catered to you
Welcome ceremony and closing intentional circle
Daily meditation, breathwork, sound healing and yoga sessions
Thai language session
Thai cooking lesson
Reflection, writing, and personal growth practices
One-on-one guidance and access to Jordana throughout retreat
Coordination of your visa and PCR tests in Thailand

EXTRAS:

International Airfare
Personal expenses (alcoholic drinks, snacks, shopping, laundry, gratuities)
Plant Medicine ceremony (if there is group interest, this can be arranged)
Private healing sessions (you will receive list of recommended healers and journeys can be coordinated for you during free time at your expense)
Extra night accommodations
Personal travel and medical insurance (required)
Required PCR / COVID-19 tests (1 is required and to be paid in advance)

GETTING INTO THAILAND:

7-30 days prior to the retreat, our team will coordinate your travel & application approval process for entry into the Kingdom through the "Test & Go" program. This program requires proof of vaccination to be provided. You will need to arrive on a "sealed" route from Bangkok or Singapore to Koh Samui and then you will receive your PCR test at the airport before your private shuttle takes you to the resort. The arrival night you will be required to spend in your beautiful accommodation where we will provide goodies & room service. If you are unvaccinated, a 10 day quarantine at an AQ hotel is required prior to the retreat start date. If this is your case, we'd be happy to help you find an accommodating hotel.

SECURE YOUR SPOT:

Non-refundable deposit of $1,000 due to secure space
Please let us know if you require a payment plan

Email *

First Name *

Last Name *

Nickname / What you prefer to be called *

Pronouns

Phone Number *

State, Country, Location *

What excites you the most about attending this retreat? *

Visiting Thailand

Meeting new like-minded friends

Deepening or beginning a meditation practice

Water activities: snorkeling, visiting the Marine national park, boating, waterfalls

Staying in a beautiful accomodation

Eating delicious and healthy food

Re-connecting with myself and self-care

Other:

Required

Please elaborate on your answers above and share any intentions you have for attending this retreat *

Do you have any dietary needs, preferences or allergies that we can be supportive of? *

Do you have any medical issues that we need to be aware of or that would prevent you from activities such as light hiking, yoga, meditation or sailing. *

What is your preferred accommodation type?

Shared room (two twin or king) with best sea views ($3,450)

Single with best sea views ($4,250)

Single with partial sea views ($3,800)

I can't make these dates and want to attend a partial retreat or 1-1 retreat

Clear selection

If you selected shared, is there someone you know who will also be attending?

Is there anything else you want us to know about you or that we can do to make your trip more enjoyable?

Do you have interest in plant medicine (mushroom) ceremony held after the retreat?

In order to enter Thailand under the "test & go" program with a short 1 night quarantine at our beautiful resort, I understand that I need to be vaccinated. If I am not vaccinated, I am required to do a 10 day quarantine and I will personally set this up or ask Peace Inside Live to support me in setting this up. I understand that COVID-19 insurance is required to enter the Kingdom of Thailand. *

I understand

Required

Who is your emergency contact? Name / relationship and phone # with email address. *

We will contact you with a confirmation and payment link for your selection. Please let us know below if you have any additional questions.

Would you like to schedule a call for questions with Jordana prior to the retreat? If so, please include your time zone and preferred days/times (please give multiple options)

Who can we thank for referring you here?

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