Peru Registration - Anahata Leadership

THE NATURE OF HEALING

October 7 – 13, 2018

Registration

Name*
First Last
Email*
Phone
Current role (if any):
Please briefly describe why you are interested in attending the retreat and what you hope to gain from it.*
Have you ever participated in an experience of deep self-reflection (i.e; coaching, therapy, healing work, etc)? What was your experience like?
Do you feel you are ready to dig deep into your emotions and belief systems in a way that might challenge them? What support do you feel you would need for that process?
Passport Number*
Can you please provide an emergency contact number and name?
Do you require an invoice for payment by, or reimbursement from, your company?
- Yes
- No
Name of company (if applicable)
Billing Address
Street Address City State ZIP Code
Do you wish to be put on the waiting list if the registration is full?
- Yes
- No
This journey is offered at the rate of $5,500 with garden single and $5,900 with luxury single. Due to the intimate nature of this journey, the group will be limited to 15 people. The retreat fee does not include flights to and from Lima, optional spa treatments and drinks.

A non-refundable deposit of $2750 is due by March 15, 2018. The final payment will be due on July 1, 2018.

Please note that the retreat will take place at an altitude of approximately 8,000 feet. Please consult your physician if you have difficultly with high altitudes.
Terms of Retreat*
- I have read and accept the terms of the retreat.
Select method of Payment*
- Payment by Paypal
- Payment by check, payable to Anahata Leadership, Inc. at above address
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Price:
Total
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