Ghana Registration | Amethyst Temple

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A mobile healing sanctuary to support individuals along their journey...

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Registration

To register, please take the time to fill out the information below.

First name

Last name

Email

Phone

Do you have a passport? (must be valid for 6 months after date of retreat)

Yes

No, but I will by the retreat

Social Media Handle

How did you learn about the Ghana Wellness Retreat?

Kemetic Yogi

Alicia

Zanetta

Social Media

Other

What's inspiring you to take a Wellness Vacay? What do you wish to receive from this experience?

What is your level of comfort when it comes to getting into the water? (pool/ocean/lagoon/river/waterfall)

Do you have any health limitations or physical injuries? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma,diabetes, seizures, osteoporosis,difficulty walking, mental health concerns, etc.)

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