Nirvana Retreats
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First Name *
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Last Name *
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E-mail Address *
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Phone number *
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The main purpose I am taking this retreat is... (may choose more than one)
I am interested in learning more....
I have the following dietary restriction....
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My experience with Yoga and Meditation is... *
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Other friends / family who would like to join are... (name / relationship to self)
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The type of accommodation I prefer (if applicable) is....
Indoor rooms are within the house, with two bathrooms on the same level. Cabins are separate, and require outdoor walk to Yoga Barn for bathrooms / shower.
Any additional information about yourself that may be relevant to this retreat:
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