Soulscape Sansara Application

First name

Last name

Phone

Have you previously attended Danielle's retreats, trainings or online courses?

Yes

If so, please list which one(s)

Which room are you interested in (if selecting a double or triple, include your roommate's name(s) in the next question)

Who will you be rooming with

If your first room choice isn't available, please choose your second option

I understand that my spot is secured only upon receipt of a 50% deposit, due within 24 hours of Danielle's confirmation. I understand that the remaining balance for the retreat is due by November 30, 2026. I also acknowledge and agree to pay a 4% processing fee if I choose to pay by credit card.

I have read and agree to the Terms & Conditions (including cancellation policy) on the website which apply in the event I am selected and decide to attend the retreat.*