| First Name |
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| Last Name |
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| Birthdate (DD/MM/YY) |
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| Email Address |
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| Available Retreat Dates |
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| Package Choice |
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| Traveling with a friend? If so, please list
their name. |
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| Mailing address (incl postal code and country) |
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| Home Phone |
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| Cell Phone |
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| Your Occupation |
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| Emergency Contact Name and Phone number |
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| Please tick the appropriate boxes and fill in information, where applicable... |
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| If you have surfed before, Please fill in the following |
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| How many years have you been surfing |
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How many times a year do you surf?
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What size waves and board do you prefer to ride...
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| Please describe your yoga experience (if any)... |
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| Spa Treatment Choice |
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| Follow Your Bliss Day Choice |
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| Do you have any allergies, medical conditions, dietary requirements (eg. vegetarian, don't eat wheat) or anything else we need to be aware of? If so please list … |
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| What would you most like to get out of the retreat
? |
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| How did you hear about us? (Please be specific
e.g. Google, guide book, magazine, friend's name etc.) |
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I have read and understand the policies and conditions |
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| Our Reservation Process... |
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After you have sent in your completed registration form, and we have confirmed availability on your desired dates, we will send you a tentative reservation confirmation via email that is valid for 3 days.
Reservations require full payment of retreat package within 3 days of the time the reservation is made or tentative booking is automatically released. |
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| Our Payment Policy... |
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| To secure your reservation, full payment is required within 3 days of receiving your tentative booking confirmation from us. Payment details will be provided once we have received your registration form and retreat availability has been confirmed. You may pay by Visa, MasterCard and bank transfer. |
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