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Costa Rica Retreat w/ Awake & Soulful LLC
Retreat Dates: August 14th-August 21st, 2021
Contract, Agreement & Waiver
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Email
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First Name
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Last Name
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Phone Number
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Home Address (Please Include the Country You Reside)
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Date
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Emergency Contact Name
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Emergency Contact Phone Number
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Emergency Contact Relation
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Passport ID Number
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Please check the box below if you DO NOT have your Passport yet, but WILL send Passport info to Gina & Elyse as soon as you acquire it.
I understand and agree
Which bed/room selection do you choose?
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Mountain View Private Room- $4100 (1 Room Available)
Private Suite Queen Bed - $3700 (3 Rooms Available)
Nature Suite KING- $2700 (3 Rooms Available)
Nature Suite TWIN- $1800 (1 Room Available)
Do you have any special dietary needs? If so, please share below.
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Do you have any mental or physical health conditions that we should be aware of before participating in this retreat?
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Is there anything else you'd like to add?
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