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MEET LILA
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AYURVEDA
0778 926 3366
New Year Yoga Retreat, Braziers Park, Oxfordshire, UK - 29th Dec 18 - 1st Jan 19
Booking Form
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Full Name
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Address
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City
State
Zip Code
Country
Email
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Mobile Phone Number
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Sex
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Male
Female
Emergency Contact
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Name/Relationship of Emergency Contact
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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, medication or special needs
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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?
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Meals on our Yoga Retreat are all vegetarian
Accommodation (Prices are per person. Please contact us for triple sharing requests)
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Shared Room - £429
Single Room - £499
Payment Amount
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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 - 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?
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How did you hear about the Retreat?
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Anything else you would like to tell us about?
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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!
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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
