Full Name(Required) First Name on Passport Last Name on Passport Passport Number(Required)Date of Birth(Required) MM slash DD slash YYYY Email(Required) I Want To Arrange a Return COVID-19 Test Through the Pura Vida Retreat & Spa(Required) Yes No Upload your proof of negative COVID-19 TestAccepted file types: jpg, jpeg, png, gif.What date are you arriving to Pura Vida Retreat & Spa?(Required) MM slash DD slash YYYY What date are you returning to your country of origin?(Required) MM slash DD slash YYYY Δ
