Mindful Detox Retreat Booking Form
Please take a moment to fill up this Retreat Form. We take your privacy very seriously. Your personally information is strictly confidential.
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Full Name *
Birth Date *
Age *
Gender *
Email address *
Phone Number *
Single/double occupancy *
All rooms are outfitted with ONE KING BED ONLY. We only recommend double occupancy if you are attending the retreat with a partner. Otherwise, we recommend that participants stay alone overnight as this is very much part of the mindful detox process.
If attending with a partner, please provide their name and age
Food allergies if any
Is this your first time doing a juice cleanse *
Have you practiced yoga before? *
Please describe your practice (how long have you practiced yoga, how often, and what type of yoga do you practice) *
Do you have any health concerns or injuries that we should know about? If so, please list and explain here.
Other comments that may be important for us to know
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