Booking Fresh Beginnings - Fast & Detox Retreat - breathe

Booking of Fresh Beginnings - Fast & Detox Retreat

NameFull name

Streetname & Number

ZIP Code & City

Phone numberWith which we can reach you the best.

E-mailA valid e-mail address

BirthdayDay-Month-Year

How fulfilling is your current life and how does your current work/life balance look like?

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How would you describe your physical and psycho-emotional health? Is there anything we should know?

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Which things/substances do you use addictively or compulsively? Are you taking any supplements medications, if so, which ones?

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How do you sleep?

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What are your eating habits these days and how much water do you drink on a daily basis?

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Do you experience often constipation, diarrhea or gas?

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Allergies & Food intolerancesPlease state if any

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Any physical or medical conditions we should be aware of

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What is your intention in attending the seminar and what would you like to gain from it?

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You have read the passage of the canellation policy and agree?

YesNo

You agree to the liabilty exclusion?Passage at the end of the booking form.

YesNo

Your messageFor questions and everything else you like us to know

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Data security

Agreed

I agree that my details from the contact form will be collected and processed to answer my request. Note: You can revoke your consent at any time for the future by emailing info@breathe-backtolife.com. You can also find detailed information on handling user data in our data protection declaration.

Disclaimer / Liability Exclusion

The participants take full responsibility for all their actions and decisions before, during and after the seminar. They can opt out of the seminar offers or cancel the seminar at any time. In the course of the seminar, internal energy blocks can be very strongly triggered and it can come to physical and emotional symptoms based, among other things, on the covered past of the human being.

Participation in all offers is completely voluntary, can be interrupted at any time and happens on the participant's own responsibility. The seminar leader will accompany this time with all her experience about physical and psycho-emotional processes, but cannot be held liable for any consequences or damage.

This seminar is not a new philosophy or religion. A loving room is created in which each participant can encounter his own inner truth.

Please read the seminar description carefully and only register if you can agree to all of the above.