Aloha! Plan your Retreat to Kauai... http://www.KauaiMagic.com/retreats/ Question Title * 1. Please tell me about you! Name Company Address City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. How many days would you like to enjoy the island? 7 days 5 days Other (please specify) OK Question Title * 3. What dates work best for you? OK Question Title * 4. Which accommodations do you prefer? Beautiful Hotel Dolphin Touch Wellness Center (small studio) I have my own accommodations Other (please specify) OK Question Title * 5. What is your intention of the trip? Adventure Healing Nutrition Sacred places Other (please specify) OK Question Title * 6. Are you intending on healing a particular event? (divorce, death, trauma, sickness or empty nest syndrome? Yes No (please specify) OK Question Title * 7. What would you like to experience while you are here in Paradise? OK Question Title * 8. What is your comfortable level of physical activity? (swimming, hiking, etc.) athlete moderate gentle (please specify) OK Question Title * 9. Please select all types of sessions that you are interested in: Dolphin Energetics (relaxing and supportive float session in a tranquil bay in the ocean) Lighthouse Session: find out what's stressing your body (a quantum biofeedback scan shines a light and shows alternatives... essential oils, bach flower essences, food, chakra info and sends balancing frequencies to support your body systems) Sacred Temple Lomi Massage Essential Oil Healing Massage Essential Oils Scan and Coaching Reiki, Divine Light or Aka Dua energy session Crystal Bowl sound therapy on the beach or in the rainbow forest Physical Therapy Symmetry Session Oracle Card Reading Acupuncture Seashell Searching Therapy Other (please specify) OK Question Title * 10. What are your food preferences? Organic Vegan Vegetarian It's all good, I can eat anything. Food allergies/sensitivities: (please specify) OK Question Title * 11. If you could wave a magic wand, what would you change in your life? OK Question Title * 12. Which activities would you like to experience? Healing Sessions Hiking to a waterfall Snorkeling Visiting sacred places: Dragons, portals, vortexes, Hindu Monastery, Rainbow Forest, Clay Therapy Beach ATV adventure Helicopter Island Tour Kayaking Luau, dancing and dinner Farmers Market Adventures Horseback Riding Boat trip to see whales or dolphins Dinner Boat Cruise up the Napali Coast Meditation in sacred places Beach and Water play Other (please specify) OK Question Title * 13. What do you long for in life more than anything? OK Question Title * 14. What is your budget for this retreat? $700 - $1000 $1001 - $2000 $2001 - $3000 $3001 - $5000 Other (please specify) OK Question Title * 15. Is there anything else you would like to share with us? OK SUBMIT. THANK YOU FOR TELLING US WHAT YOU WANT!