Yandara Registration Form

Email Address

Phone Number:

How did you hear about this retreat?

Which room option would you like?

Options: Luxury Tepee with 2 individual beds Luxury Tepee with 1 King bed Ocean View Suite with 2 Queen Beds Ocean View Suite with 1 King Bed If you have any questions about room types, let us know!

Do you have a chosen roommate? If so, whom?

Note: Each attendee needs to complete their own form unless they are your children and/or spouse AND you will be making payment together.

Are you planning to travel solo?

Note: If you are traveling solo and would like to share a room, we are happy to match you up with someone of the same gender.

Do you have any food allergies or dietary restrictions we will need to accommodate?

(Note: Vegetarian meals can be provided ONLY if requested beforehand, so we can prepare the chef.)

Have you been on a retreat before?

If so, where?

What is your main objective for coming on this retreat? What do you hope to gain? Is there anything about your mental/emotional state you would like us to know?

Please feel safe to share anything you wish. Your responses will be kept confidential.

Please list an emergency contact:

Name: Relationship: Phone: Email:

Once you submit this form, we will email you with direction on how to pay your $800 deposit to secure your space. Please let us know if you prefer to pay via check, bank transfer, Venmo or Paypal.

Note: Paypal will incur a 3% processing fee.

Any questions for us? We are happy to answer them!

If you have never met Laina in person, she will be reaching out via phone to get to know you a bit before the retreat!