Langkawi Retreat Application

We would love to get to know you better! Please take a moment to complete the short questionnaire below. Once your application has been accepted, there will be a $500 deposit to secure your spot.

Name

First Name

Last Name

Email Address

Location

Select your dates:

Tell us a little about yourself!

Please describe your experience with yoga.

Note: No prior experience is necessary

Have you ever been on a yoga retreat?

If yes, please share more about your experience(s).

What has inspired you to go on retreat?

Is there anything you would like your retreat hosts to know?

Please include any physical conditions, injuries / limitations, history of mental illness, medications currently being taken, etc.

Do you have any allergies or dietary preferences?

Please select your room option.

Do you have a preference for roommate?

If so, please enter their name(s) below or note "single".

How did you hear about us?

If you were referred by a friend, please share their name so we can send them some love!