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The Empowered Self Yoga & Meditation Retreat
Please fill out this form to register for the retreat. Once received, payment instructions will be sent to the email address provided. Please note that room options are based on availability and bookings are not considered confirmed until your payment is received.
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Full name
*
Your answer
Date of birth
*
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YYYY
Email address
*
Your answer
Please input your email address again and ensure that both inputs match
*
Your answer
Nationality
*
Your answer
Room request
*
Choose
Garden room shared occupancy US$500 per pax
Riverside room shared occupancy US$525 per pax
Riverside room single occupancy US$585 per pax
If you would like to share a room with a PARTICIPATING friend, please provide your friend's name below.
Your answer
If you are attending with a NON-PARTICIPATING partner, please provide your partner's name below.
Your answer
Yoga and meditation experience
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Please tell me a little bit about your experience with yoga and meditation. How many years have you been practicing? If you have a meditation practice, what meditation technique do you work with?
Your answer
What is your intention for participating in this retreat
*
Your answer
If you have had any past trauma or injury, please very briefly describe below.
Your answer
How would you like to make your payment?
*
Payment is requested in full. Your spot on the retreat is not confirmed until payment is received. Cancellation policy: FULL REFUND until August 31st; 50% REFUND from September 1st until October 9th; NO REFUNDS after October 9th.
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Direct bank transfer (USD)
Direct bank transfer or PayNow (SGD)
Credit card USD (5% fee will be added)
Credit card SGD (3.5% fee will be added)
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