We’re so glad you’re here.

This form helps us understand who you are, your intentions, and any support you may need so we can hold a safe, nourishing space.

Once we’ve reviewed your application, we’ll be in touch with next steps.

Your Details *

First Name

Last Name

Email *

Phone *

Country

(###)

###

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About You *

Tell us a little about who you are, in your own words.

Your Intention *

In a few words, what is your intention for joining Untamed?

Are you booking with a friend?

What is there name?

Room Type *

Please select which room you would like to reserve

ROOM ONE: Twin Share Deluxe

ROOM TWO: Twin Share Deluxe

ROOM THREE: Twin Share Terrace

ROOM FOUR: Co-Regulation

ROOM FIVE: Co-Regulation

Flexible: Twin Share Deluxe

Flexible: Co-Regulation

Your Investment *

To make this retreat as accessible as possible, we offer both payment plans and full payment options. Which feels right for you?

Payment in Full

Payment Plan: Monthly Installments

Payment Plan: Fortnightly Installments

Deposit Requirements *

I am aware that a $1000 deposit is required to secure my spot

I am ready to pay

I am interested, but don't have the deposit ready

Other

Your Wellbeing Needs

Do you have any specific needs, health considerations, or requirements we should know about to support you safely during the retreat?

Anything Else?

If there’s anything not covered above that feels important for us to know, please share it here.

Application Process *

I am aware that this retreat is in high demand and reserved for 10 women only. I will do my best to communicate efficiently with Mana Temple knowing that a lack of reply may forfeit my position

Yes

Thank you!

Chelsey will be in touch with you soon.

ARE YOU STUCK IN SURVIVAL STRESS?

Access to my FREE QUIZ to understand your nervous system and see how your survival systems are tracking.

First Name

Last Name

Email Address

Click HERE to take the quiz

CONTACT HOME FIND US

In the spirit of reconciliation, Mana Temple acknowledges that we live, work and grow roots on the stolen and unceded territories of the Dja Dja Warrung peoples. We honor the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

TERMS & CONDITIONS

PRIVACY

UNTAMED: The RetreatApplication Form

UNTAMED: The Retreat
Application Form