International Yoga Registration Form:
Personal Information:
I am inquiring about: (choose retreat)
Retreats
Bali.................Oct 2 - 9 2010
Greece...........Oct 3 - 9 2010
India...............Oct 23 - 30 2010
Bali.................Nov 13 - 20 2010
Bali.................Jan 16 - 23 2011
India...............Jan 22 - 29 2011
India...............Jan 29 - Feb 4 2011
Bali.................Jan 23 - 30 2011
India...............Feb 6 - 13 2011
India................Feb 13 - 18 2011
First Name :
Last Name:
Phone Number:
Email:
Confirm Email:
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Other Information:
*Do you have a Pre-existing Medical Condition?
If so, Please list your medical details here.
*Do you have any Special Dietary Requirements?
Accomodations:
If you are traveling alone:
Would you prefer to have individual accomodations
or to be matched with a roommate?
Individual accomodation rates vary and will be an additional cost.
a) Roommate
b) Private Accomodations
If you are traveling with someone,
Please list your traveling companions:
Additional Requests:
Terms and Conditions:
Read the Terms and Conditions
Click Here
I have read and agree to the Terms and Conditions:**
In submitting this reservation form, you acknowledge that you have read, understood and accept the Terms & Conditions accompanying this booking and the obligations set out in the conditions, particularly those relating to the release and waiver of liability.
* Requests without an email address will not be submitted.
** Requests without Terms and Conditions approval will not be submitted.
