First, Middle and Last name exactly as your PASSPORT shows
First, Middle and Last name exactly as your PASSPORT shows
DD/MM/YYYY
If you are registering with someone who will be your roommate, please give their First and Surname name
If you are registering with someone who will be your roommate, please give their First and Surname name
YOUR CONTACT INFORMATION
Postal Address *
Postal Address
ABOUT YOU
Please provide your favourite colour, include the tone and shade of colour.
I prefer asanas (postures) that are *
Please tick your preference:
I’m interested in learning pranayama (breathing techniques) *
Please tick your level of interest:
I am interested learning meditation *
Please tick your level of interest:
I am interested and enjoy mantra chanting *
Please tick your level of interest:
I am interested in learning about the psychology and philosophy of yoga, eg: benefits, Chakras and Elements. *
Please tick your level of interest:
ACCOMMODATION REQUIREMENTS:
The fee is based on twin share accommodation, for a single room there is a single supplement of $260 for the Bali Retreat. Please understand in high season we cannot guarantee the availability of a single room.
Do you snore? *
TERMS & CONDITIONS
The following boxes must be ticked, indicating that you have read, understand and agree to all points stated. To secure your booking all boxes must be ticked.
I understand and agree: *
Full Name *
Full Name
TYPE YOUR EMAIL ADDRESS: I have read and agree to the cancellation and Terms and Conditions Policy. I agree that by submitting my name, the date and my EMAIL address below, this hereby constitutes my signature.
DD/MM/YYYY
Acknowledgement