Booking form | Serenity Eco Yoga Retreats
Please fill the form below to join the next retreat!
Email address *
Your first and last name *
Your answer
Your answer
Phone Number or Whatsapp
Your answer
Gender *
Health Information
We treat health Information with the strictest confidence. The following questions are merely here to help us keep the Serenity Eco Yoga Retreat experience safe and enjoyable for all.
Based on your answers below we may reach out to you to make sure that the Serenity Eco Yoga Retreat program is the right choice for you.
Please answer with yes or no
Are you currently taking medication for any physical or psychological condition?
Do you have any chronic physical limitations or disabilities?
Do you have a history of psychological or emotional illnesses, or issues?
Do you have a communicable disease?
Have you had a serious illness or major surgery within the last five years?
Are you currently pregnant or trying to become pregnant?
If you answered YES to any of the above questions, please provide us with more relevant details as it would pertain to the Serenity Eco Yoga Retreat program. As well, please describe if there is anything else you feel we should know with regards to your participation in the program here:
Your answer
Who do we contact in case of emergency? *
Your answer
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Phone Number/ Whatsapp
Your answer
Email Address *
Your answer
Please Select the Retreat period *
Number of person joining the retreat
Your answer
Have you studied any yoga before? If "Yes", How long have you been practicing yoga??
Your answer
Do you have food sensitivities or allergies?
Food preferences
Room option *
Motivation and Interest
What are the main things you expect to get out of the Serenity Eco Yoga Retreat?
Your answer
Are there any activities you are especially interested in while in Bali, such as trekking, surfing, visiting temples etc?
Your answer
How did you hear about Serenity Eco Yoga Retreat?
By completing and returning this application form you understand and accept the requirements for the retreat.
Serenity Eco Yoga Retreat has the concept to know the healthy life and activity of Balinese people. Applicants are invited to get to know the Balinese culture, spiritual cleansing in holy water, yoga session and philosophy, visit the Permaculture area. All come together to create a unique life changing experience in Bali.The activities you do at this retreat will also be immortalized with photos and videos by our photographers.

Benefits of joining Serenity Eco Yoga Retreat are to enrich your knowledge of the yoga philosophy, the Balinese culture, feel a strong spiritual by cleansing your body in holy water, healthy living by doing yoga. Time to slow down, to cleanse, and rejuvenate your body, mind and spirit.

To secure your spot on the retreat, a 25% deposit is required after approval of your application.

The remaining balance will be paid upon arrival at Serenity Eco Guesthouse.

A copy of your responses will be emailed to the address you provided.
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