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Holistic Parenting Mama & Child Retreat registration form
Dear Mama, thank you! We are so thrilled to have you join us!
Please fill out the necessary information so we can get in touch with you.
Important reminders:
Who can register: Mamas and Kids under 4 years old.
Upcoming retreats: (7 days, 6 nights)
22-28.02.2020
1-7.03.2020
Retreat location: Ubud, Bali. Detailed location will be communicated by email.
To secure your spot, you will be asked to pay a $500 USD deposit (non-refundable).
Upon receiving this registration form, we will send you the details for the deposit payment.
There are only 7 spots available. The minimum of 5 participants are required to run the retreat. Under 5 participants, the retreat will be posponed and the deposits refunded.
More information and questions:
info@transform-retreat.com
or WA: +6281339489056
* Required
Email address
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Your email
Which retreat week are you signing up for:
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Choose
February 22-28, 2020 (Ubud/Bali)
March 1-7, 2020 (Ubud/Bali)
Your full name (name and surname)
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Your answer
Your whatsapp number (with the country code):
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Your answer
Your full Facebook name:
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Your answer
Your date of birth:
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MM
/
DD
/
YYYY
Your child's name:
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Your answer
Your child's date of birth:
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MM
/
DD
/
YYYY
Where are you travelling from?
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Your answer
Which country are you from?
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Your answer
Your dietary restrictions/allergies
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None
Vegetarian
Vegan
Gluten-free
Dairy-free
Other:
Your child's dietary restrictions/allergies:
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None
Vegetarian
Vegan
Gluten-free
Other:
Please tell us a few words about yourself, your child and why you are willing to participate in this retreat.
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Your answer
How did you find out about the retreat?
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Your answer
How would you like to pay your deposit ($500 USD + transfer fees):
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Choose
PayPal
Transferwise
International bank transfer
Cash
Submit
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