BALI SURVEY

Mar 10

PLEASE COMPLETE NO LATER THAN APRIL 15TH SO WE CAN MAKE NECESSARY ARRANGEMENTS FOR YOU. ONE PER PERSON. CONTACT LINDSEY WITH ANY QUESTIONS

Full Legal Name on Passport

First Name

Last Name

PASSPORT NUMBER

Passport must be valid until Decemeber 2025 at a minimum

Dietary Restrictions

We will do our best to accommodate all dietary restrictions

No Restrictions

Gluten Free/Celiac

Dairy Free

Vegetarian

Shellfish Allergy

Nut Allergy

Pescatarian

Swag Style Preference

We will provide this in your swag bag. View the options from the images below

Swag Size

Use the size charts below. The do run true to size. Size up for looser fit.

How many Awaken Retreats have you attended?

Instagram Handle

Arrival Travel Plans

What date does your flight land?

YYYY

What time does your flight land?

Hour

Minute

Second

What is your flight number arriving into DPS?

For Delta, example DL 1234

Departing Travel Plans

Return Shuttle to DPS only for June 8

If you are extending your stay, you will be responsible for arranging your return transportation

Departure Flight Time for June 8 ONLY

If leaving on June 8th, please list what time your flight departs. We will account for travel -

Hour

Minute

Second

RECOMMENDED TRAVEL INSURANCE

Massage Sign Up - Bali