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Event / Visitor Registration
BY SUBMITTING THIS FORM WITH YOUR EMAIL ADDRESS, YOU ARE CONFIRMING YOUR REGISTRATION IN THE EVENT, SUBSEQUENT EXPECTED PAYMENT FOR THE EVENT IS AGREED TO, AND THAT THE INFORMATION IS CORRECT TO THE BEST OF YOUR KNOWLEDGE. THE EMAIL ADDRESS BELOW IS THE ONE WHICH WE WILL USE FOR ALL COMMUNICATIONS WITH YOU ABOUT THIS EVENT.
Email *
Course / Event Name *
Required
Full Name *
Spiritual Name (optional)
Street Address *
City/State *
Country / Post Code *
Date of Birth
MM
/
DD
/
YYYY
or please state your age (must be over 18) *
Home Phone Number
Mobile Phone Number *
Email address preferred for your Deposit or alternate payment method if this has been discussed
I will require additional accommodation time before or after the event *
I speak sufficient English and will not require translation for the duration of the Visit *
First Language Spoken
Additional Languages
Dietary restrictions *
*this is an alcohol, drug, meat, & smoke-free holy Hindu pilgrimage town*:meals are vegan by defaut/ local dairy option
Health Concerns (you will be offered options based on Yoga Therapy)
Are you a Registered Yoga Teacher? *
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