Peru Registration Form
Mobile Phone Number:
Home Phone Number:
Your Name as it appears on your passport
Date of Birth
How did you hear about this retreat? Please specify: Romy, Email, Facebook, Instagram, friend name.
Emergency Contact Name & Information
Where are you coming from?
Tell me about your yoga and meditation experience? Which styles of Yoga and where? How long have you been practicing Yoga?
Single Room Garden
Double Room Garden
Triple Room Garden
Single Room Luxury
Double Room Luxury
Triple Room Luxury
Would you like to be matched up with a roommate?
Do you snore?
What is your level of fitness?
Do you have any physical injuries or limitations?
What aspects of the retreat are you most interested in and looking forward to?
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