JOIN US IN COSTA RICA

Nov. 21-28 2026

START BY FILLING OUT OUR APPLICATION HERE:

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Have you attended a retreat with us before?

YOUR STORY: Please write freely using the prompts below; there are no right answers here.

What is drawing you to Equilibria Costa Rica right now?

What excites you the most about Costa Rica?

What excites you the most about working with James and Debra?

What feels alive, inspired, or perhaps needs clarity in your life that makes this the moment?

What do you most hope to carry home from this experience?

In your own words, describe your current relationship with your health, energy, and sense of purpose.

Do you have any injuries, health conditions, or mobility limitations we should be aware of?

Do you have any food allergies or dietary preferences?

Are you attending with someone else?

Yes

No

If yes, who are you attending with?

Room Preference:

Shared Room (with friend/partner)

Shared Room (pair me with another guest)

Private Room (single occupancy)

We will do our best to provide impressive rooms for your stay. Rates are per person, double occupancy, and include 7 nights, 3 meals daily, movement and mindfulness sessions, and all sacred ceremonies.

If you are applying as a single, are you willing to share accommodations that would include your own bedroom in a 2-bedroom casita?
Roommate preference (name, or leave blank if you need a match): __________________________________________________________
Please let us know if you have any special needs or requests regarding your stay: ________________________________________

Are you comfortable participating in (check all that apply):

Daily movement/fitness sessions

Group-based dialogue or reflection

Silent meditation practices

Shared meals and social time

Intentional breathwork or nervous system regulation

How would you describe your current physical activity level?

I move daily and feel strong

I move occasionally but want to do more

I'm just getting started and ready for a reset

I have injuries or limitations (see below)

Please describe injuries or limitations:

Have you ever attended a wellness or transformational retreat before?

Yes

No

I understand that this is a high-integrity, transformational retreat involving physical movement, breathwork, group experiences, and nervous system work.

I Agree

I have questions

I understand the $1,000 deposit is non-refundable, and all cancellation policies apply.

I Agree

I have questions

I agree to the Equilibria Community Agreement.

Is there anything else you’d like to share with us about your journey, intentions, or needs?

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

Month

Day

Year