First name *

Last name

Email *

WhatsApp phone number *

Please add your WhatsApp Phone Number, if you want to be added to the WhatsApp group with all attendees (we'll post all updates there, recommended!)

Gender * — Female Male Other

Room sharing gender preference

*If available for your room type

— Same gender I don't have a preference I have the Workshop ticket; I don't have a room

Retreat duration *

This is only for indication! You can change your mind later. Reserving the trips and volcano hike can only be done during the retreat, by paying it. It can't be full, we'll just arrange more busses and guides 😉

— - Retreat only - leaving on May 4th + Trips until May 6th + Full experience Trips + Volcano hike until May 8th

Food preference *

This is only for indication. The buffet will have all the options, but this will help the restaurant to estimate.

— Meat Vegetarian

Workshops of interest *

This is only for indication, you can still change your mind later, we just want to have an idea of your interest

Poi Meteor Hoop SilkFans Tech Fans Contact Staff Staff Spinning Double Staff Staff Juggling (Double Staff) Dragon Staff Acro Dance Yoga Bellydance

Prop rental *

We also need to fly them in, so we're asking rent to cover the flight costs. The rental fee is for the whole retreat. If you change your mind after submittin the form, please contact Nana about your changes +336 3456 0233 WhatsApp

No, I'll bring all of my own props Poi — 5 euros Hoop — 10 euros Silk Fans — 5 euros Staff Spinning Staff — 5 euros Double Staffs — 5 euros yoga mat - free to use

T-shirt size *

What is your T-shirt/Tank-top Size? EU sizes. (For USA sizes, take one size bigger!)

— S M L XL XXL

Facebook

We would like to connect with you on Facebook, if you would also like that, please provide the full address of your FB account, example: https://www.facebook.com/nana.berben/

Emergency contact

Emergency Contact name and phone number (with country code)

How did you hear about this retreat * Facebook Instagram Newsletter Poi Retreat Flyer/ Poster on a festival Google search Juggling Calling Vojta Luke Lucero Zera Mel Tim Alexander

Questions or additional comments

If you have any food allergies, please list them here.