Wellness Experiences Interest Form

Name(Required)

First Last

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

What is your age range? (We are asking for demographic purposes as this is a multi-generational women's-only getaway)(Required)

Your Individual Preferences

Please select the specific wellness activities or practices you are most interested in incorporating into your wellness getaway. Please select up to 5 options.(Required)

Which option best describes how you prefer to balance relaxation and adventure during your travels?(Required)

I prefer mostly relaxation with minimal adventure.

I like a balanced mix of relaxation and adventure.

I prefer mostly adventure with minimal relaxation.

Please select the types of scenery that you find most rejuvenating. Please select up to 3 options.(Required)

Mountains

Beaches

Forests

Deserts

Countryside

Urban landscapes

What type of cultural experiences would you enjoy during a wellness getaway? Please select up to 2 options.(Required)

Visiting local museums or art galleries

Participating in traditional cooking or culinary classes

Exploring historical landmarks or heritage sites

Engaging in indigenous or local crafts workshops

Immersing in local festivals or celebrations

None of these

Which itinerary style best suits your preferences?(Required)

A more structured itinerary with planned activities.

A more flexible approach with free time for exploration.

Have you experienced a wellness retreat or getaway before?(Required)

Please share your experience: What was the destination of your previous wellness experience? What did you enjoy the most about your experience? What would you change for your next wellness experience?(Required)

Please select your personal wellness goals or intentions you have for this wellness experience. Please select up to 3 options:(Required)

Stress relief

Mindfulness

Enhancing physical fitness

Spiritual growth

Emotional restoration

Relaxation and rejuvenation

During the getaway, what areas would you enjoy having expert guidance in. Please select up to 3 options:(Required)

Mental Health

Parenting

Skin Care

Body Image

Spiritual Growth

Fitness

Nutrition

Elevating your internal compass/reconnecting with self

Please select the option that best describes your current health and fitness level:(Required)

Low - I have limited physical activity and may have health concerns.

Fair - I engage in light physical activity occasionally.

Moderate - I participate in regular physical activity and have average fitness levels.

High - I engage in consistent physical activity and maintain good fitness levels.

Very High - I am highly active and have excellent fitness levels.

How important is group interaction and socializing to you during a women's-only wellness experience?(Required)

Extremely important - I value connecting with others and building relationships.

Moderately important - I enjoy some group activities but also appreciate alone time.

Not very important - I prefer solitude and individual reflection.

I have no preference - I’m comfortable with whatever level of group interaction occurs naturally.

What type of accommodations do you prefer?(Required)

Luxurious and upscale

Rustic and off-the-beaten path

What time of the year works best for you to travel?(Required)

Q1: January - March

Q2: April - June

Q3: July - September

Q4: October - December

For a women's-only getaway, would you prefer to travel with a female companion, or do you prefer to room alone? Please note that you would need to arrange your own companion, as we do not pair people up or match roommates.(Required)

I will travel with a female companion

I prefer to room alone

Would you be comfortable sharing a bed with your female companion, or would you prefer separate beds?(Required)

We are comfortable sharing a bed

We prefer separate beds

Do you have children in your household under the age of 18?(Required)

Do you prefer to travel with your children?(Required)

Do you have any health or mobility considerations we should be aware of when planning activities and accommodations for you? Check all that apply.(Required)

None

Dietary restrictions

Physical mobility limitations

Accessibility requirements for accommodations or activities

Please provide details regarding your health or mobility considerations:(Required)

How much are you willing to invest annually in your personal wellness and self-preservation for a luxury getaway, excluding the cost of airfare?(Required)

$3,500 - $5,000 per person

$5,000 - $7,500 per person

$7,500 - $10,000 per person

$10,000 - $15,000 per person

$15,000+ per person