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Eros Rising
Application Form
Full Name
*
Birthday (Must be 21+)
Month
Month
Day
Year
Email
*
Phone
*
Are you attending as a single or couple?
Social Media (Optional - Instagram, etc.)
What draws you to Eros Rising?
Experience with sensuality, tantra, or embodiment retreats?
Please share your understanding of consent & boundaries?
Intentions for the retreat?
Dietary restrictions or medical concerns?
Emergency Contact
Preferred time for vetting call?
File upload
Upload File
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