South Africa Application

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Apply to Return to the Motherland Retreat
in South Africa Nov 22-28, 2026

If you have already applied in the past, you can resubmit your name HERE.

All other retreats can be found HERE

Enter your details below:

First Name

Last Name

Which retreat are you applying to? (You can apply multiple times if you'd like to submit for different retreats!)

General Waitlist

Bali (Sept 21-26, 2025)

Costa Rica (March 23-29, 2026)

Bali (May 24-29, 2026)

Peru (June 18-25, 2026)

Tuscany (July 31 - Aug 5)

Mallorca (Aug 9-15, 2026)

Portugal (Sept 28 - Oct 3, 2026)

Iceland (Oct 11-17, 2026)

South Africa (Nov 22-28, 2026)

Phone Number

Age

Where are you located?

Gender

We try to be as inclusive and diverse as possible to ensure representation! Please select the race and/or ethnic identities you identify with. This is voluntary!

Education

What do you do for work?

Do you have any kids? (We like to connect mommas with each other!)

Have you ever been to a retreat before?

How did you hear about us? (choose option below)

Instagram

Tiktok

Google Search

Word of mouth

Other

What account led you to us? (choose option below)

Coherence Retreats social media

Kimberly Kennedy (Founder)

Other Host - Regina, Kristin, Lexi

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Google Search

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Not Sure

What is YOUR social media handle? Ideally for Instagram (if not, TikTok). Where can we find you!?

Describe yourself in 3 words

Name 3 to 5 things that you're passionate about

If money didn't matter...What would you be doing with your life?

Tell us more about yourself!

What is your intention for coming to a retreat? Why do you want to join?

What's your zodiac sign!?

Emergency Contact Name + Phone Number

Do you own a valid passport?

Do you have any physical, mental, or other health conditions we should be aware of to best support you during the retreat?

Dietary preferences or food allergies?

Any other allergies?

I understand that my deposit and any additional payments towards the retreat are non-refundable

I understand that the full price must be paid 45 days BEFORE the retreat begins.

You have read and agree to the TERMS & CONDITIONS (Can be found at bottom of website)

Yes

Join Our Free Trial

Get started today before this once in a lifetime opportunity expires.

Apply to Return to the Motherland Retreatin South Africa Nov 22-28, 2026

Join Our Free Trial

Apply to Return to the Motherland Retreat
in South Africa Nov 22-28, 2026