Retreat Request Form Name * First Name Last Name Cell Phone * (###) ### #### Email * What type of event are you looking to book? One Time Class, Reoccurring Class, Social Event, Work Related, Charity, etc. If this is a reoccurring class? If so, how often? Daily Weekly Monthly 5 Classes 10 Classes What type of activities would you like? * Yoga Reiki Sound Bath Crystals Workshop Other, please specify below Activity not listed above How many people do you wish to have? What is the ideal date for your event? Please choose a date you'd like to have your In Studio retreat, I can not guarantee it will be available but we will start there. MM DD YYYY What time would you like your event to being? Hour Minute Second AM PM Would you like to use Long Island Vibes' Private studio? * located in Manorville, NY (full address given upon registration) Yes No, I have another location in mind, please specify below Address Address 1 Address 2 City State/Province Zip/Postal Code Country 60 Minute Activities Please check all that you're interested in Beginner Yoga Vinyasa Yoga Restorative Yoga Partner Yoga 30 Minute Activities Please check all that you're interested in Release Meditation Aura Cleanse Manifest Meditation Aura Reading Sound Bath Reiki Treatment Chakra Balance 90 Minute Activities Please check all that you're interested in Psychic Reading Tarot Card & Numerology Workshop Manifest Workshop Protect Your Energy Workshop Birth Charts & Astrology Reading Message Any additional questions? Thank you!