Let’s Go to Thailand

I am so excited that you are considering going with me to Asia! Thailand is a magical country, so I chose this destination because it is a beautiful place to explore and expand.

I am asking you to fill out this application to ensure that my retreat will meet your needs. We have limited space. We want to make sure that this retreat is a good fit for you, and that you are a good fit for this retreat.

Name

First Name

Last Name

Email

Phone

(###)

###

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Age

Ethnicity

Any physical or mental disabilities?

What most describes why you want to attend this Brooke Brimm Retreat in Thailand?

I need to heal, rest, figure things out, and I want to do it in a beautiful environment.

I want to explore the beauty, culture, food, and magic of Thailand. it's on my bucket list.

How did you hear about us?

Anything additional you want us to know?