ENGLISH RETREAT REGISTRATION FORM - JULY 2020
SPIRITUAL RETREAT IN ENGLISH
Wednesday 29th July to Sunday August 02, 2020

Venue:
Ashirbhavan Retreat Centre
Banerji Road,
Kacheripady
Kochi, Kerala 682018

Tel. +91 484 239 0472 (Retreat Centre)

For questions regarding filling of the form:

- Call:
Mrs. Bindu Roshan : 9633144777 (India) or
- Send a WhatsApp message or call :
Ms. Jeanne Dias : 00971-55-5569439 (UAE)


Directions: To locate the Retreat Centre on Google Maps, please click this link: http://bit.ly/2Hi6d7l

Tariffs: For room rates, please click this link: bit.ly/2HJDPKS

Email address *
GENERAL INSTRUCTIONS:
Kindly arrive at the Retreat Centre before 5 pm on Wednesday July 28, to complete Registration formalities and room allotment.

REGISTRATION FEE (inclusive of food and accomodation): Please refer to tariff link above

HOW TO PAY:
To be paid at the Registration Counter on July 29 2020
INSTRUCTIONS FOR FILLING UP THIS FORM
For questions which are starred (*) and are not applicable to you, please enter N.A.

You will be contacted by email or telephone to confirm your reservation.
PERSONAL DETAILS
Title *
Full Name *
Your answer
Age *
Choose your age range
Community
If you belong to a Religious Community, kindly enter the name of your Community here
Your answer
CONTACT DETAILS
Email *
If you do not have an email address, please enter 'N.A.'
Your answer
Mobile/Land Telephone *
Your answer
Address *
Enter your full address
Your answer
Emergency contact *
Enter the name and address of nearest relative or friend to contact in case of an emergency. If you wish to leave this field blank, please enter 'N.A.'
Your answer
Emergency Contact Number *
Enter the telephone number of the person to be intimated in case of an emergency
Your answer
Type of booking *
GROUP BOOKINGS
To be completed by those who have chosen 'Group' above.
Please note that every person who accompanies you (including your children, spouse, relatives or Community members) must be registered by entering their details below.
How many people are in your Group (including yourself)
Please note the maximum number possible in a Group is seven
Names of all the Group Members
Your answer
How many children do you have in your Group?
Enter the age group of your children
Check all the age ranges that apply
Enter the details of the people accompanying you
Check all the categories that apply. Please note that those who do not belong to the categories below will have to register individually
OTHER DETAILS
Diet *
Room preference *
Please refer to the tariff link above for room rates.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy