Nusa Penida Retreat

7 nights of bliss on spectacular Nusa Penida Island

Sunday 25 May 2025 - Monday 2 June 2025

Join us for AU$2899

Congratulations!

Thank you for registering for the Nusa Penida Retreat 2025!

We are thrilled to hosting for this exciting and rejuvenating experience.

Please complete your registration by providing us with the following details:

(these questions are designed to help us craft a unique experience for you)

First name

Last name

Phone

What's App Number

Address

Birthday

Day

Month

Year

Passport Number

Passport Issue Date

Passport Expiration Date

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Any pre-existing medical conditions? Please list.

Are you pregnant?

Yes

Dietary Requirements: any food allergies, or special dietary needs?

Medication: information about any medication you will be bringing.

Fitness Level: to tailor activities appropriately, describe your fitness level on a scale of 1-10.

Interest in Specific Activities: yoga, meditation, sound healing, adventure activities, etc.

Swimming ability: what is your level of confidence in water?

Have you ever been on a boat?

Do you get sea sick?

Yes

Payment Schedule Agreement: Confirmation of understanding and agreement to the payment schedule and terms. A non-refundable deposit of 30% ($966AU) of the retreat cost is required to secure your booking. Full payment is required 60 days prior to the retreat start date. (Bank transfer required.)

Previous Retreat Experience: what is your previous experience?

Goals for the Retreat: what are your personal goals or intentions for attending the retreat.

How did you hear about the retreat?

Consent to Terms and Conditions: I agree to the retreat’s terms and conditions. I acknowledge I have downloaded, completed and returned the Agreement, Waiver & Disclaimer, Liability and Assumption of Risk Form.

Consent to Use of Photographs: I grant permission to use photos of me taken during the retreat for promotional purposes.

Yes

Are you excited, Hell Yeh!