REGISTER YOUR SPOT FOR ASLI’S WOMEN’S WELLNESS RETREAT IN DUBAI DEC 24-27th in Dubai, UAE info.asliwellness@gmail.com Name * First Name Last Name Phone (###) ### #### Email * Country and City of Residence * Date of Birth * MM DD YYYY Emergency Contact Name * First Name Last Name Emergency Contact Phone * (###) ### #### Do you have any physical or medical conditions we should be aware of? (e.g., injuries, chronic conditions, etc.) Do you have any allergies or dietary restrictions? (e.g., gluten-free, vegan, dairy-free, etc.) Are you currently pregnant or postpartum? * NO YES Postpartum YES Pregnant What is your current experience level with Pilates or other movement practices? * Beginner Intermediate Advanced None I would like to Opt out of this class What aspects of the retreat are you most excited about? (Select all that apply) * Art Therapy Pilates/Body Connection Healing Circles Self Love & Care Workshops Cultural Exploration Meeting other like minded women Is there anything you’re currently working through emotionally or spiritually that you hope this retreat will support? (Optional but encouraged) How do you currently feel in your relationship to your body, culture, or identity? * Have you ever participated in a women’s circle, support group, or similar space before? Yes No You will share a luxury cabin with one other individual. Do you want to be matched with a specific roommate you know is attending? If yes, please list their name. If you would like your own cabin, please check mark here (Extra fees will apply) You will receive a separate email with price and information I would like my own cabin and acknowledge extra fees will apply To reserve your spot, a deposit of $600 is required. Do you agree to this and understand the cancellation policy? * Cancellation Policy: The $600 deposit is non-refundable, as it secures your spot and helps us book accommodations, facilitators, and materials. You may cancel within 72 hours of payment for a full refund. After 72 hours, the deposit remains non-refundable unless we are able to fill your spot from our waitlist. Remaining Balance: Details regarding the remaining balance and installment options will be emailed to you upon confirmation of your registration. Full payment must be completed by the deadline stated in that email. Yes No Do you consent to receiving emails and updates from Asli Wellness? * YES NO
