Booking form: workshops at Viveka Gardens
Om! We're looking forward to hosting you at Viveka Gardens. Please complete this form and make your payment (see the end of the form). See you soon. Om Shanti.
Email address *
name *
Your answer
mobile and/or landline (both preferred)
Your answer
Name and date of workshop
book two retreats or more at the same time up to Christmas for you and/or friends attending together and get 10% off the total
How did you hear about Viveka Gardens or this workshop
can I add your name, email and postcode to the newsletter database? *
I send a monthly newsletter and sometimes special offers
postcode *
this helps me sort local from national participants
Your answer
landline
Your answer
emergency contact *
Your answer
emergency contact email *
Your answer
emergency contact mobile *
Your answer
emergency contact landline *
Your answer
previous yoga experience (briefly) *
Your answer
what do you hope to gain from the workshop? (briefly) *
Your answer
Can you offer or would you like a lift? Where are you coming from? Fiona will try to match for lift sharing.
Your answer
Please let us know if you are affected by any of these. Please be in touch if you'd like to talk it over. *
Please give details or add anything else you think we should know about. *
Your answer
Please tell us about any food allergies (write 'none', if none) *
Your answer
promotion code or offer (if any)
Your answer
Please indicate how you are paying
Payment in full required on booking. The workshop fee is transferable up to 1 week before the workshop start. You are welcome to transfer your place to a friend (no additional cost) or you can transfer onto another workshop for a £11 admin fee. Cancellation refund possible (minus 20%) if we are able to fill your space up to one week before workshop. Should we have to cancel the workshop you will be refunded in full but we cannot pay for any travel you may have bought. Each participant to complete a form, please.
Amount paid and any notes (eg names of other people you are paying for or have paid for you)
Your answer
I agree to take full responsibility for myself and for my personal property. The decision to participate in the activities is my own responsibility. In addition I agree that I will not hold Viveka Gardens responsible for any injuries or damages that might result from my participation in any of the activities. 'Sign' by typing your name and date
Your answer
Thank you. Now please LET US KNOW you have completed the form and sent payment, using this email, fiona.law{at}hotmail.co.uk. See you soon. Om Shanti.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms