Personal Information

Thank you for your interest in Temple Somatics: The Immersion. Please complete this application to help us understand your background and readiness for this deep somatic work. Your responses will remain confidential.

Phone *

Email *

Last Name *

First Name *

Name you prefer to be called *

How did you hear about Temple Somatics: The Immersion?

Country *

City *

Age *

Background & Information

What types of healing modalities, somatic practices, or personal growth work have you experienced? (Examples: therapy, bodywork, breathwork, tantra, ceremony, coaching, energy work, etc.) *

Have you participated in immersive workshops, retreats, or trainings focused on somatic healing, sexuality, or embodiment? *

yes

If yes, please briefly describe:

Do you work as a practitioner, bodyworker, coach, or healing facilitator? *

yes

If yes, please describe:

Readiness & Comfort Level

Are you currently working with a therapist, counselor, or somatic practitioner? *

yes

prefer not to answer

If yes, do they know you're applying for this immersion?

yes

not applicable

Is there anything about these practices that gives you hesitation or concern? (Optional - helps us support you better)

Do you have any trauma history (sexual, physical, emotional, medical) that you'd like us to be aware of? This is optional, but understanding your history helps us create a safer container for you. Please share only what feels comfortable.

This work includes partnered practices with sacred touch, vocal expression, breathwork, and emotional release. Are you comfortable with:

Giving and receiving consensual, non-sexual touch (hands, arms, back, legs, feet, etc.)

Eros-inclusive practices, which may include consensual touch in and around the genital area when appropriate and with full permission

Using your voice (sounding, toning, emotional expression)

Working in dyads and triads with other participants

Emotional release practices (grief, anger, fear)

Your Intentions

What do you hope to experience or discover during these six days? *

Why do you want to participate in Temple Somatics: The Immersion? What draws you to this work at this time? *

Logistics & Accomodations

Do you have any physical limitations, injuries, or health conditions we should be aware of? (This helps us adapt practices as needed and ensure your safety) *

Dietary Preferences & Allergies Please share any dietary needs, restrictions, allergies, or food preferences so we can plan meals accordingly. *

Accommodation Preference *

Do you have any physical limitations, injuries, or health conditions we should be aware of?

Emergency Contact Name *

Emergency Contact Phone *

Relationship to you *

Agreement & Consent

By submitting this application, I understand and agree to the following: * *

This immersion involves deep somatic and emotional work, including partnered practices with consensual touch. While sexuality is not the sole focus, it is an essential aspect of this work, and practices may include eros-inclusive healing and, when appropriate, consensual touch in and around the genital area

All practices are consent-based, and I have the right to say no or modify any practice at any time, whether giving or receiving

I am responsible for my own self-care and will communicate my needs and boundaries clearly

The information I provide will be kept confidential and will be viewed only by Triambika and her team for the purpose of evaluating my application and supporting me during the immersion. Except for legal requirements for safety reasons

I understand that participation in this immersion is at the discretion of Triambika and her team, and acceptance is based on readiness, fit, and availability

Today's Date

Is there anything else you'd like us to know? (Optional)

After submitting, you will receive a confirmation email. We review applications on a rolling basis and will be in touch within 5-7 days regarding your acceptance and next steps.