Surfin2yoga Retreat Application
First & Last Name *
Your answer
Date of Birth *
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Home Address *
Your answer
Occupation *
Your answer
Room Type / Lodging Preference *
How did you hear about this YogaKoh retreat? *
Yoga Experience
How long have you been practicing yoga? *
What are your favorite poses?
Your answer
What are your least favorite poses?
Your answer
What styles have you studied? *
Required
Do you have a meditation practice? If so, what techniques do you practice?
Your answer
What are the main things you want out of this retreat? *
Your answer
Health
Dietary restrictions *
Allergies *
Favorite Foods... the things I cannot live without!
Your answer
Do you have any healthy conditions that may affect your stay? *
Do you have any current or past injuries? If so, please explain. *
Your answer
Weekly activity level *
Favorite activities
I have surfed before *
What is your surf level / ability? *
Travel  
Where will you be traveling from? *
Your answer
Have you been to Bali before? *
Do you have travel insurance? *
In case of emergency please contact (Name & Number) *
Your answer
Payment Terms and Conditions
Payment Terms and Conditions

Payment is due as follows:
- 500USD upon registration (non refundable)
- the remaining amount no later than 30 days before the first day of the course

Refund policies:
Cancellation 14 days or more before the first day of the course: 70% of the amount paid to date (outside of non-refundable deposit)

Cancellation 7-14 days before the first day of the course: 50% refund of the amount paid to date (outside of non-refundable deposit)

Cancellation within 7 days of the first day of the course: 30% refund of the amount paid to date (outside of non-refundable deposit)

After first day of course: no refund.

Payment methods:
You can pay via bank transfer (fees included), or cash upon arrival.. Please let us know your preferred payment method and we will give you our details.
The Retreat Fee Includes:
All listed inclusions.

The Course Fee does NOT include:
Airfare

By completing and returning this questionnaire form, you understand and accept the Payment Terms and Conditions and the Requirements for attending the retreat.

Signature (Type Name) *
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Date *
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