In order to register for The Healing Heart of Bali retreat, please scroll down and
complete the form below:

If you have technical difficulties with this form or have additional questions, you can contact Laura’s assistant, Jen, by email at jpeachtree23@gmail.com or call 330-421-0111 (Jen is on Eastern Time and is available most weekdays from 7 am PT/10 am ET until 3 pm PT/6 pm ET).

Bali Single Registration 2025 - Stage 1

Name*
First Last
Email Address*
Enter Email Confirm Email
Billing Address (exactly how it appears on your credit card bill).*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing address for retreat business (if different).
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
Cell Phone
Payment
Retreat Options (Each Price Listed Is Per Person)*
- DEPOSIT PAYMENT ONLY: Single Occupancy Room - $1,500
- PAY IN FULL: Single Occupancy Room - $7, 250
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Coupon
Total
$0.00
Credit Card

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Terms and Conditions
Please take a moment to access the terms and conditions, health and safety policy, and cancellation policies for this trip. Then return here to complete your registration. The terms and conditions and cancellation policy for this trip can be viewed here. The health and safety policy can be viewed here. (Links will open in a new window/tab).
Agreement*
I HAVE READ AND AGREE TO THE HEALTH AND SAFETY POLICY, THE CANCELLATION POLICY, AND THE TERMS AND CONDITIONS FOR THE HEALING HEART OF BALI TRIP. If this field is not ticked, you won't be able to proceed and complete your registration.
- Yes, I accept the health and safety policy, cancellation policy, and the terms and conditions for this trip.
Would you like to be added to Laura's email list?*
- Yes! Sign me up to get weekly writing prompts from Laura, to receive occasional blog posts, and to stay in touch with future workshops.
- No. I'd prefer not to be added to the list.
- Thanks for asking. I'm already on Laura's mailing list!
Email
This field is for validation purposes and should be left unchanged.

Please note: The system will take a moment to save your registration; please do not navigate away from this page while it saves. Once your registration is saved, the system will direct you over to Stage 2.

In order to register for The Healing Heart of Bali retreat, please scroll down and complete the form below:

Bali Single Registration 2025 - Stage 1

Payment

Terms and Conditions

A Gift to Inspire Your Writing

In order to register for The Healing Heart of Bali retreat, please scroll down and
complete the form below: