Pura Vida 2022 Questionnaire

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

Date of Birth *

MM

DD

YYYY

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

Country

(###)

###

####

Vegetarian Breakfast + Lunch is included daily. Do you have any dietary restrictions? *

Yes

No

I will be creating a communication email for our group for this retreat. Is it okay to share your email address with our group? *

I will create an email thread so we can communicate with one another, coordinate flight or schedules, and ask general questions for planning the retreat.

Yes

No

I will be creating a communication thread for our group via WhatsApp. Is it okay to include your phone number with our group? *

The WhatsApp Group will help us communicate with one another during our trip and planning. We can share flight or schedule changes, photos, and videos of our experience while we’re there, etc.

Yes

No

I will be connecting the group on Instagram. Is it okay to share your IG handle with our group? *

I will create an IG Group so we can connect with each other, tag each other, and document our experience while we're there.

Yes

No