WORK WITH ME
1:1 – 90 minute Soul Immersion session
YOGA + MEDITATION
WORKSHOPS + RETREATS
SOUL GLOW BALI – WOMEN’S SELF LOVE RETREAT APRIL 25TH – MAY 1ST 2020
SOUL ELEVATION DAY RETREAT
Soul Glow Bali Retreat Registration Form
Mobile phone number
Date of Birth
Have you been to Bali before?
Level of Yoga experience
Never done before
Ive done a few classes here and there
I know what Im doing
Do you have any current injuries? If yes please list
Do you have any current health issues? If yes please list
Do you suffer from any Mental health issues? If yes please let us know
Are you taking any medications? Please list
Do you suffer from any allergies? If yes please list
Do you have any food allergies/aversions?
Do you follow a specific diet? Vegan, Gluten Free etc?
Do you snore?
Emergency Contact - name, email, mobile and address
What drew you to this Retreat and how did you hear about it?
What would you love to get out of this retreat?
Are you willing to be moderate in your use of electronics during our retreat?
Is there anything else you would like us to know?
Release form - I agree that by submitting my name and the date below, this hereby constitutes my signature and agreeance to the below release form
Release Form: I understand that I am solely responsible for my health and safety, and will not hold retreat leaders responsible for any loss, injuries, or illness that may occur. I will consider the interests of the group, but know that I may participate in as many or as few of the activities as I like. Please note: To insure a safe and sacred a space, we do not allow alcohol at the retreat center itself. Thank you for understanding and agreeing.
Copyright @soulsparkle 2016