To help us assess whether this retreat is aligned with where you are in your life right now, we ask you to fill out this form with presence and honesty. All information will be treated confidentially.
Would you like to receive news & updates? YesNo Country of Residence? AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo (Congo-Brazzaville)Costa RicaCroatiaCubaCyprusCzechia (Czech Republic)Democratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (fmr. Swaziland)EthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestine StatePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe What attracts you to the Freedom Retreat? What are you currently struggling with in your life, health or work? What would you most love to shift, deepen or heal? What is your intention for this retreat? What would feel like a meaningful result for you? How do you currently feel physically, mentally and emotionally? Are you willing to participate in physical, mental and emotional practices such as breathwork, cold exposure, silence, movement, and deep self-inquiry? Yes, fullyYes, with some hesitationNo / Prefer not to Do you have previous experience with retreats, embodiment work, breathwork or personal development? Yes, regularlyYes, a few timesNo, this would be new for me What type of accommodation do you prefer (depending on availability)? Basic Tent (single)Glamping Tent (single)Glamping Tent (shared)Yurt (single)Yurt (shared)Not sure yet Would you like to bring someone or participate with a partner/friend? YesNo If yes, who are they and what is your relationship? Do you have any physical or mental health conditions we should be aware of? Are you available for a short online intake call? Yes, I'd love thatOnly if I seriously consider joiningNo Is there anything else you’d like to share with us? I understand that the Freedom Retreat is not a holiday, but a deep process of transformation. If selected, I am willing to participate with openness, curiosity, and personal responsibility. Yes, I agree
