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First Name *

Last Name *

Birthdate *

Which gender best describes you? (select one) *

Preferred email address to receive updates on your retreat (please use this same email in the checkout). *

Phone Number *

To add you to our group WhatsApp chat. Please include your country code.

Do you have any allergies or dietary restrictions? Please select all that apply from the list below. *

Please note that we cannot accommodate all dietary restrictions. We reserve the right to refund your retreat minus a 5% administrative fee if you have an allergy or restriction that cannot be accommodated, so please email manager@reprecisionhealth.com in advance if you have any severe allergies or dietary restrictions. Our food is served buffet style; it is a paleo style menu (gluten, dairy, corn, refined seed oil-free). We can only offer limited vegan and vegetarian options because they do not fit with our gut healing protocol.

Do you have any injuries that would prohibit you from taking part in physical exercise? *

Although we can't personalize the classes for everyone, please let us know if you have any injuries or conditions that the movement practitioners should consider in preparation for their group classes to better serve you. Examples are sprains, fractures, torn ligaments, herniated disc, arthritis, mobility concerns, etc. (If you have specific concerns and would also like a more customized experience, we recommend booking private sessions with our practitioners at an additional cost)

Are you booking double occupancy and bringing a second guest? *

Yes

No

I am the second guest

Second Guest First Name *

Second Guest Last Name *

Second Guest Email *

Booking Guest Full Name *

How did you hear about us? *

I understand that it is my responsibility to confirm that the program and modalities are suitable for me and I will sign the waiver prior to arrival. *

I understand that the location is in the jungle where there are bugs, steep and uneven terrain, as well as occasional power cuts. *

I understand that there is a zero-tolerance drug and alcohol policy. Consumption of drugs (non-prescribed) or alcohol on or off-site will result in removal from the retreat. *

I understand that there is a no refund policy and my retreat dates cannot be changed. This is to be able to offer as low pricing as possible. *

I understand that at least 70% participation in program activities is required. This is to maintain the group dynamic and to ensure that guests are prepared for the activities towards the end of the program. *

To get the most out of my experience, I will sign and follow the Agreements upon arrival. You can review them here. *

Is there anything else we should know?

I agree to receive guest communications about my retreat. Please do not unsubscribe from our emails or you will miss important communications about your upcoming retreat *

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