Colleena Shakti in Bali December 2019
Thank you for your interest in our retreat!

Please take a moment to fill in your details and answer a these questions, to help us make sure your retreat experience is beautiful and unforgettable :)

Once we have received and processed your registration details, we will email you a Paypal invoice.

Please note that Paypal charges a 5% fee, which will be added to your invoice. You may request other payment options:
- sending money through Paypal as a gift to so you don't pay extra fees.
- transferring to a UK Bank Account - all transfer fees are yours.

All payments will be received in GBP Pounds Sterling.

***Please email us once you have completed the registration form!***

The closest Airport is DENPASAR, BALI.
check in is from 2pm.
Checkout is by 12pm.
Please contact us immediately if you require extra nights.

If you have further questions please contact us at

Information will soon be available here and

PLEASE NOTE - your place on the retreat is not confirmed until we have received your full payment or deposit.
Space is limited as we are in a private villa this year, so we advise you to send the completed registration form as soon as possible to ensure your place - we SOLD OUT last year!

All payments are non-refundable. However they are transferable to another participant - if you find someone to take your place.

We respect your privacy and your information will not be shared with third parties.

Thanks again! We can't wait to dance with you!


Before completing your registration we want to be sure you understand and agree to the REFUND POLICY.

• Cancellations 6 months before the event will receive 100% refund (Paypal Fees will be paid by applicant)
• Cancellations 3 months before the event will receive 50% refund (Paypal Fees will be paid by applicant)
• Any cancellations after this will receive no refund.
• All Paypal fees / bank transfer fees will be paid by applicant.

*By completing your payment, you have agreed to our refund terms and conditions.

These terms hold even in the case of personal accident or family emergency as we will have paid our 3rd parties.

We reserve the right to make any changes to our programme in the case of teacher cancellation, low bookings, natural disasters or any other situation beyond our control. In this very unlikely case, alternative arrangements will be offered to the best of our ability but we do not accept responsibility for any costs incurred, including airfares.
Email address *
Your Legal Name *
First and Last Name (please add any other nicknames in brackets)
Age *
Nationality *
Country of Residence *
Passport information *
Name - Date of Birth - Passport Number - Country Issued - Expiry Date
Occupation *
Your Facebook profile *
Package you are registering for *
Accommodation rates are based on double share unless otherwise specified
Group Details
If you are coming with a friend/friends and want to share a room, please write the names of all participants in your group
How would you like to pay *
some people prefer to receive a paypal invoice, some people prefer to reduce transfer fees by sending as a "gift". PLEASE NOTE! We must receive the full amount as stated above, so any money missing due to transfer fees of any kind, is your responsibility and must be paid.
How would you like to pay part 2 *
some people prefer to pay directly in full. Some people prefer to pay a deposit first. Please note that if you choose to pay in 2 parts, the balance is due by 31st October 2019
What styles of dance do you practice regularly? *
Have you ever studied with Colleena? *
Do you have any experience in Indian Dance? If yes, please explain *
any prior workshops, classes or intensives in any style of Indian dance
Do you, or have you ever practiced yoga?
Have you had any formal dance training?
Please list what, when
Do you have any injuries which may prevent you from training intensively? *
if yes, please explain
Do you have any health condition (physical or psychological) that we should know about? *
If yes, please let us know in case we need to help you
A dance retreat is NOT therapy. Please remember that you are responsible for your own physical, mental and emotional health and wellbeing. *
Who should we contact in case of an emergency? *
contact name - telephone number - email - country of residence - relationship to you
How did you hear about this retreat? *
Please explain what attracts you to join us in this intensive study *
Please be aware that we will be taking photos & video for future promotional material *
Would you like to be picked up from the airport (at the additional cost of $40 one way)
if yes, please give your complete flight details - arrival time, flight number, airline, flying in from where (last port of call in case you were in transit)
Do you have any other questions or concerns you would like to share with us
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