First Name

Last Name

Email

Phone

Country

(###)

###

####

Nationality

Why do you want to take this training?

Do you identify as a woman if you are in a female body or a man in a male body?

Are you currently being treated, or have you ever been treated, for any mental health conditions such as PTSD, psychosis, chronic anxiety, bipolar disorder, or sleep disorders that required medication or hospitalization?

Yes

No

If yes, please provide more details about your treatment for these mental health condition.

Are you currently taking or have you been prescribed any psychiatric medications?

Yes

No

If yes, please list the names of the medications and what they are for, such as blood pressure, seizures, or asthma.

Coupon

Awakening the Akasha Through Amaterra Tantra

Once we receive your form, we will reach out to you with a warm welcome and share all the next steps.

To secure your place in the retreat, a non-refundable deposit of €250 is required.

For all details about cancellations and refunds, please take a moment to read through our Payment & Refund Guidelines — simply click here to learn more.

info@agapiapostolopoulou.com