Thank you for booking with us!

for your

WOMEN’S SACRED IMMERSION

Embodied Energy Alchemy

Canggu, Bali, Indonesia

April 25-27th, 2025

Our aim is to ensure that you receive the best experience possible. Please fill out the following form so that we can get to know you a little better in preparation for our 3-day immersion. Feel free to add anything you would like us to know in advance and to ask any questions that we can answer for you in the lead up to our immersion.

Name

First Name

Last Name

Email

Age

Dietary Requirements

Do you have any physical health concerns that we should be aware of?

Do you have any mental health conditions that we should be aware of?

Are you on any medication?

What would you like to gain from this immersion?

Do you have any questions for us in the lead up to your immersion?

Is there anything else you would like us to know in preparation for your immersion?