18-22 January Retreat Booking Form Name * First Name Last Name Email * Date of Birth * MM DD YYYY Phone number * Country (###) ### #### About You * Please introduce yourself to us in as much detail as you are comfortable to Which of the retreat activities are you particularly drawn to? * Yoga Pilates Meditation Breathwork Personal Development/Coaching Sound Bath Experience Hikes Fitness Dance Fitness All of the above What experience do you have in any of the retreat activities offered? You do not need to have any prior experience to come on the retreat Are you interested in any of the following activities? (which will involve an additional cost) Ayurvedic massage 1-1 Life coaching Boat trip Private class (yoga, pilates, fitness, meditation or dance) What time do you plan to arrive? * Do you have any dietary requirements? * How did you hear about this Retreat? * Do you have any further questions? Thank you!
