Intuitive Rebirth Retreat Application

Please complete this short application form. We will be in touch within 4 working days.

With love

The Intuitive Rebirth Team

Click the button below to start your application. 


Question 1 of 13

Full Name

Question 2 of 13

What is your email address?

Question 3 of 13

What is your current country of residence? 

Question 4 of 13

Are you currently enrolled in the Intuitive Rebirth Practitioner Training online?





Question 5 of 13

Do you currently work in the healing arts in any capacity? 


Yes, I am a healer of other modalities


I am transitioning into the healing arts slowly.


No, not yet!

Question 6 of 13

Please describe any experience that you have that feels relevant to this training. For example, other retreats, other modalities, spiritual experiences etc. Please be as detailed as you feel necessary so that we can get to know you better at this unique stage of your journey. 

Question 7 of 13

What is your motivation for joining the next Intuitive Rebirth Practitioner Retreat? What do you hope to get out of this experience? 

Question 8 of 13

Beyond a practitioner training, this retreat will be a deeply healing experience that unearths all that no longer serves you, to be transmuted back to love.

Is there anything that we need to know about your life journey to best guide and support you through this transformation experience? 

(We honour your privacy. We honour your vulnerability. Please share from your heart anything that feels relevant.)


Question 9 of 13

Should your application be accepted, you will be notified by email but we would like to connect with you either via Whatsapp or Instagram. Which of these platforms can we reach you on?





Question 10 of 13

What is your Instagram handle or Whatsapp number? 

Question 11 of 13

This practitioner training is upwards of $3000 usd (depending on the venue. Exact prices are listed on the previous page.)

This price includes your 7 day practitioner training experience, food and accommodation. This price also includes access to the online training program that can be accessed for assistance and integration before and after the retreat.

If your application is accepted, we will send you a payment link to secure your spot (valid for 7 days).

Would you prefer the link to make your payment in full, on 2 month payment plan - or last minute special 4 month payment plan?



Pay in full


2 x monthly installments


Last Minute Special 4 x Monthly Installments

Question 12 of 13

When you are an Intuitive Rebirth Practitioner, how do you envision yourself making an impact in the world? 

Question 13 of 13

What are your dietary requirements?

Confirm and Submit