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Retreat in English

Retreat Application

First Name*

Last Name*

Email*

Phone/WhatsApp*

Birthday*

Month

Day

Year

Choose Your Retreat*

March 14 - 24, 2025

September 2025

What are your intentions/goals for joining this retreat?*

Experience in healing modalities (yoga, meditation, breathwork, energy healing, Plant Medicine, etc.)*

Experience in Adventure Travel (Hiking, trekking, cold plunging)*

Dietary Restrictions or Allergies?*

Medical conditions or pharmaceutical use?*

Hotel Room Preference*

Private Room

Shared Double Room

Do you have a valid passport?*

Yes

No, I will work on it

Anything else we should know? (Special requests, phobias, questions)*

To secure my spot, there is a $500 deposit required. I understand this deposit is non-refundable.

Retiro en Español

Aplicación para Retiros

Nombre*

Apellido*

Email*

Numero/WhatsApp*

Cumpleaños*

Month

Day

Year

Escoje Tu Retiro*

16 - 21 de abril, 2025

Otras fechas 2025

Cuales son tus intenciones al unirte a este retiro?*

Experiencia en modalidades de sanación (Yoga, Meditación, Medicina Ancestral, Reiki, etc)*

Experiencia en viajes de aventura (Trekking, inmersión en hielo, alturas)*

Alergias o Restricciones Dietéticas?*

Condiciones médicas o consumo de farmacéuticos?*

Preferencia de Hotel*

Cuarto Privado

Compartido Doble

Tienes permiso de viajar en las fechas del retiro?*

Sí

No, voy a gestionarlo

Algo más que deberiamos saber? (Instrucciones especiales, miedos/fobias, preguntas)*

Para asegurar tu cupo, un deposito de S/ 500 es requerido, entiendo que este monto no es reembolsable.

LIBERTI

BREATHWORK

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