Booking form for retreats at Viveka Gardens
Om! We're looking forward to hosting you at Viveka Gardens. Please complete this form and then contact us to arrange payment (see the end of the form). See you soon. Om Shanti.
Email address
name
Your answer
Which retreat would you like to attend?
address
Your answer
email
Your answer
mobile
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 retreat? (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
Payment in full required on booking. If you can't make it for some reason the retreat fee is transferable to another retreat up to 3 weeks before the retreat start (£11 admin fee). You are also welcome to transfer your place to a friend (£11 admin fee). Cancellation refund possible (minus 20%) if we are able to fill your space up to three weeks before the retreat. Should we have to cancel the workshop you will be refunded in full but we cannot pay for any travel you may have bought.
Please confirm you have read the retreat information, rules, Ts & Cs, http://vivekagardens.com/retreat-information-rules-ts-cs/, and are happy to go along with this. 'Sign' by typing your name and date
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