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AYURVEDA
0778 926 3366
Spring Equinox Yoga Retreat, Earth Spirit
Booking Form
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Indicates required field
Full Name
*
Retreat Date
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Friday 20 - Sunday 22 March 2020
Email
*
Mobile Phone Number
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Sex
*
Male
Female
Emergency Contact
*
Name/Relationship of Emergency Contact
*
Are you driving & willing to car share?
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Yes
No
Yoga Experience
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Complete Beginner
Have practiced a little yoga
Practice regularly
Intermediate
Yoga Teacher
What style of Yoga do you practice (if known)
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Hatha Yoga
Sivananda
Ashtanga
Iyengar
Kundalini
Other
Do you have a Meditation practice?
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Yes, regularly
Yes, occasionally
No
Do you need to borrow a yoga mat?
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Yes please
No, I have my own mat
Please let us know of any medical problems or medication
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Please include any old injuries, recent surgery, if you have heart problems, high or low blood pressure. Are you taking medication?
Are you pregnant?
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No
Yes
Do you have any food intolerance or foods that you can not eat? All meals are Vegetarian
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Meals on our Yoga Retreat are all vegetarian
Accommodation (Prices are per person. All accommodation is shared. Please contact us for single occupancy, triple requests)
*
Shared Twin/Triple ensuite - £265
Twin shared (bathroom outside) - £250
Twin/Dbl Caravan (bathroom outside) - £240
Single Caravan (bathroom outside) - £269
Payment Amount
*
I would like to pay in full
I would like to pay £100 deposit
I would like to pay another amount (please use the comments box below to give more info)
Payment Options (please contact us if you need to pay in installments)
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Bank Transfer -Miss C Conway, A/C 44177860 sort 30-62-96 (LLoyds Bank). Please put your name as a reference when sending payment.
If you would like to share a room with a friend, what is their name?
*
How did you hear about the Retreat?
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Additional Information
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All information provided will remain confidential and used only for Yoga Retreat purposes. Please be advised a deposit secures your place. Any remaining balance must be paid 4 weeks before the retreat start date. Deposits are non-refundable. We cannot credit, refund or transfer any balance within 4 weeks of retreat start date or once the retreat has started. We really look forward to sharing the weekend with you!
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I understand my own body’s challenges and take full responsibility for my own practice
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Agree
If you are unsure about practicing yoga due to a medical complaint, please consult your medical practitioner or doctor
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HOME
CLASSES
CLASSES
BOOK A CLASS
PRICES & PASSES
VIDEO LIBRARY
WORKSHOPS/COURSES
RETREATS
TRAINING
YIN YOGA TEACHER TRAINING
HORMONE YOGA TRAINING
MEET LILA
CONTACT
AYURVEDA
