apply below say, “yes” to saturnia, italy Name * First Name Last Name Email * Phone * Country (###) ### #### Mailing Address * How would you like Jackie to contact you? * Via email Via text/iMessage Via WhatsApp Via Phone Call Any of the above How did you hear about the retreat? * What interests you about the retreat? * Have you ever practiced meditation? * Yes, all the time! I practice sporadically. I've tried it, but I don't practice regularly. I've tried it, and it's not for me. I'm excited to try! Have you ever practiced yoga? * Yes, all the time! I practice sporadically. I've tried it, but I don't practice regularly. I've tried it, and it's not for me. I'm excited to try! Do you have any mindfulness practices? Ritualized routines? Please feel free to share as much or little as you feel comfortable. * This retreat is an investment (financially, emotionally, energetically) in your growth. Not the kind that requires you "hustle hard" or "just push through", but the kind that invites you to soften into presence, beauty, connection, and pleasure. Are you ready to commit to yourself in this way ~ to say yes to easeful transformation, soulful nourishment, and experiences that expand you gently (but also meaningfully)? (Please feel free to take up space and share anything that may have come up for you with this question!) * What room type are you interested in? * Private (double bed for one) Private (double bed for two) Shared room (single bed) Shared room (double bed for one) Shared room (double bed for two) If interested in a shared room: * I'm booking and traveling with a friend I'm coming solo and will be sharing with a new friend What rate are you interested in? * Discounted paid in full $750 deposit with 5 monthly payments $750 deposit with 10 bi-weekly payments Please list any dietary restrictions (or note that you have none). * Please list any physical injuries, conditions or surgeries that impact your physical or mental health (or note that you have none). * Please list your emergency contact information (name, phone number, email) as well as your relationship to them: * Please use this space if there is anything else you'd like to share that you feel may be relevant. Thank you! Please allow 3-5 business days for a response.
