Name
*
First Name
Last Name
Email
*
Gender
Date of birth?
*
MM
DD
YYYY
Phone
Country
(###)
###
####
Where will you be traveling from?
*
Is there anything in particular you would like to share in why you have chosen this retreat in particular?
*
Is there anything you think we should be aware of in regards to your story, trauma or your calling to join? Please know - anything you share is with strict confidence and when on the retreat you are only encouraged to share what you feel comfortable with.
*
Please tick all that apply to you below
*
Please list if you have any allergies and/or dietary requirements
Accomodation is twin share $2500aud payment plans available. Please initial if you agree
*
Upon application approval a deposit of $700aud is require to secure your place. Please tick below how you would like the payment split?
*
Have you previously engaged in practices such as Breathwork, meditation, somatic healing, kundalini activation or other forms of holistic healing?
*
What are you hoping to achieve or embody through healing?
*
Are you currently investing in yourself with healing, therapy or self care? If yes - please detail
*
What do you wish to change in your future?
*
Are you ready to fully commit to your healing?
*
Are you ready to willingly meet all aspects of yourself, painful aspects and all?
*
Are you ready to dive deep into your being and show up for yourself through all aspects?
*
Are you ready to choose the path that will create change and new beginnings?
*
I, the Participant, voluntarily participate in the Healing Immersions with Cate Porter and Aesha Mukerji and accept full responsibility for my own physical, mental, emotional and spiritual wellbeing. Initial if you agree below
*
Securing your spot on the retreat involves a few steps: 1. Application Approval: Once your retreat application is approved, you'll be eligible to secure your space. 2. Deposit Payment: A deposit of $700aud is required within 7 days of application approval. Upon receiving this deposit, we will update your balance and issue a new invoice based on your chosen payment option. This payment plan must be paid in full no later than 30 days prior to check in date. Invoices will be sent out on specific dates, and timely payment is essential to secure your booked dates. We want to ensure that any cancellations are handled smoothly: * Cancellations: All requests for cancellations must be provided in written form. We appreciate as much notice as possible. * Refund Policy: The initial deposit of $700aud is non-refundable regardless of cancellations. If a cancellation is made more than 75 days of the check-in date a refund of 50% of paid amount (not including the $700 deposit) will be honored. If a cancellation is made within 75 days of the check-in date, unfortunately, none of the paid amount is refundable. * Last-Minute Bookings: For bookings made within 60 days of the retreat start date, at least 50% deposit payment is required within 48 hours of booking confirmation. For bookings made within 30 days of the retreat start date, full payment is required within 48 hours of booking confirmation. Please note that such bookings are non-refundable. We value your understanding of these terms and conditions, which are designed to create a balanced and transformative retreat experience for all participants. Feel free to reach out if you have any questions or need further clarification.
*
Is there anything else you would like to share with us? If so, feel free to use this space to share
