Gaia Wellness Deposit Form
Please carefully fill in the form below with your credit card information. Your deposit will be processed within 24 hours of submitting the form or by the next business day if you submit over a weekend. Your information will not be shared.

Please Note: Booking reservations/sessions cannot be confirmed without a deposit.

Thank You
-The Gaia Wellness Team-

www.gaiawellnessretreat.com
info@gaiawellnessretreat.com
613-894-4242
Email address *
Arrival Date *
MM
/
DD
/
YYYY
Name on Card *
Card Type *
Card Number *
Expiry Date *
CVV - Number on the back of the card *
I authorize Gaia Wellness Retreat to use this card to process my deposit. *
Would you like a copy of the deposit receipt emailed to you?
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