Please fill out the application form.

We look forward to hearing from you!

tantricembodiment@gmail.com

Application Form

First Name

Last Name

Gender

Age

Whatsapp Number

Country

(###)

###

####

Country

Instagram or Facebook account

How did you hear about us? Did someone specific refer you?

Do you have any injuries or health issues?

Tell us about your sexual health, anything we should know?

Please specify psychiatric history, diagnosis or psychological therapies undertaken?

Are you currently taking medication? If yes, please specify the type:

Are you using tobacco, alcohol or recreational drugs? Please specify:

Prior experience in Yoga, Tantra, Massage or other Spiritual Work: (please name teachers, schools)

Reason for attending this retreat? What do you hope to gain from this experience?

Name 3 things you love about yourself:

Primary diet

Any food allergies or special requirements?

Emergency contact, their relationship to you and their contact details:

Any additional information about you?