Application to attend
The TSI Spiritual Transformation Retreat
on the Caribbean Coast of Mexico
March 17th-24th, 2009
Congratulations! You are about to embark on an amazing adventure with like minded souls.
We want you to have the best experience possible, so please fill out
this form and send to us as soon as possible to assure your place in
the retreat. If you are coming with friends or a partner, please fill
out one form per person.
Please copy this page, paste in a email, fill out the form, and E-MAIL to: info@tantricshamanism.com
If you can't figure out how to copy the page, just send a request for an email version of the application at this email address, and we will be happy to send it to you.
Thank you.
______________________________________
Your Name
_______________________________________
_______________________________________
Address
_______________________________________
City, State, Zip
______________________________________
Telephone number
______________________________________
Birth date
What is it that you are most interested in doing on this retreat?
Please mark each the following with a 1-5 grading scale. 5 means its a high priority, 1 means a low priority. Put a number by each activity.
___ Experiencing Mayan Culture
___ Experiencing Mayan Shamanism
___ Rest and relaxation
___ Shamanic healing rituals
___ Meeting new Friends
___ Walking on the beach
___ Meditation
___ Learning new things
___ To receive healing
___ Seeing the ancient Mayan Sites
___ Snorkeling
___Other _____________________________________________
I prefer to eat:
____ chicken and fish
_____ only fish
____ vegetarian (Lacto-ovo)
____ vegan
I have dietary restrictions. They are:
_____________________________________________________
We will do our best to accommodate varying dietary needs. However, if you have a very restricted diet, you may have to bring some special things along, or purchase them in town to supplement your diet. Much of the food will be typical Mexican fare.
Are you on any medications? If so, what are they?
____________________________________________________
Do you have a medical condition we should know about?
_______________________________________________
Emergency contact name and telephone number:
____________________________________________________
The airport nearest to my home is:
_____________________________________________________
(If you like we can help you find the cheapest airfare available.)
Accommodations
We have several choices for accommodations. The different choices
change the price of the retreat. Please tell us your first and second
choices.
I would like to stay in:
______Double Cabana (two beds) ($1400 per person)
______ Double Cabana with one double bed ($1480 per person)
I would like to room with:
_____________________________________________________
If you are coming alone, would you prefer to room with:
____ Women ____ Men _____ Either
Deposit:
A non-refundable deposit of $600 is required to hold your space. The entire retreat fee total is due by February 1st, 2008. Payment can be made by check, cash, money order, paypal or by credit card. We do prefer checks, cash or money orders when possible.
Checks and money orders should be send to:
Sylvia Brallier
191 Redwood Way
Boulder Creek, Ca 95006
Paypal or Credit Card payments can be made here:
How did you find out about this retreat?
Internet _______________________ (what site?)
Brochure _____
A friend _____________________________________ (who?)
in a publication ______________________________ (which one?)
Please feel free to direct any of your questions to Sylvia at (831)338-2346, or info@tantricshamanism.com
More trip details can be found on the "more information" page.
We're really looking forward to sharing the magic of this retreat with you.
Sincerely,
Sylvia Brallier
Director of the Tantric Shamanism Institute
and the Staff of TSI
www.tantricshamanism.com
