Booking form - New Year Retreat 2018, Braziers Park

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New Year Yoga Retreat, Braziers Park, Oxfordshire, UK - 29th Dec 18 - 1st Jan 19
Booking Form

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Full Name *

Address *

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City

State

Zip Code

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Email *

Mobile Phone Number *

Sex *

Male Female

Emergency Contact *

Name/Relationship of Emergency Contact *

Are you driving & willing to car share? *

Yes No

Yoga Experience *

Complete Beginner Have practiced a little yoga Practice regularly Intermediate Yoga Teacher

What style of Yoga do you practice (if known) *

Hatha Yoga Sivananda Ashtanga Iyengar Kundalini Other

Do you have a Meditation practice? *

Yes, regularly Yes, occasionally No

Do you need to borrow a yoga mat? *

Yes please No, I have my own mat

Please let us know of any medical problems, medication or special needs *

Please include any old injuries, recent surgery, if you have heart problems, high or low blood pressure. Are you taking medication?

Are you pregnant? *

No Yes

Do you have any food intolerance or foods that you can not eat? *

Meals on our Yoga Retreat are all vegetarian

Accommodation (Prices are per person. Please contact us for triple sharing requests) *

Shared Room - £429 Single Room - £499

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) *

Bank Transfer - Account Number 44177860, Sort 30-62-96, Miss C Conway, LLoyds Bank Cheque - payable to C Conway, postal address - 12 Dod Lane, Glastonbury, BA6 8BZ Cash (in person only)

If you would like to share a room with a friend, what is their name? *

How did you hear about the Retreat? *

Anything else you would like to tell us about? *

All information provided will remain confidential and used only for Yoga Retreat purposes.Places are not confirmed until the retreat deposit has been received. Full payment is required 4 weeks before the retreat start date. No refunds, credits or transfers will be given 4 weeks before, during or after the retreat has started. It may be possible to pay in installments, please contact us. We really look forward to sharing the weekend with you! *

I understand my own body’s challenges and take full responsibility for my own practice *

Agree

If you are unsure about practicing yoga due to a medical complaint, please consult your medical practitioner or doctor

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New Year Yoga Retreat, Braziers Park, Oxfordshire, UK - 29th Dec 18 - 1st Jan 19Booking Form

Subscribe to our mailing list

New Year Yoga Retreat, Braziers Park, Oxfordshire, UK - 29th Dec 18 - 1st Jan 19
Booking Form