Booking form: workshops at Viveka Gardens 2020
Om! We're looking forward to hosting you at Viveka Gardens.
for more information and how to opt out.
Please complete this form and make your payment (see the end of the form). See you soon. Om Shanti.
Sign in to Google
to save your progress.
mobile and/or landline (both preferred)
Name and date of workshop
see the website for yoga and nidra day retreats
How did you hear about Viveka Gardens or this workshop
word of mouth
flyer or poster
If you would like to receive the newsletter please opt in here
I send a monthly newsletter and sometimes special offers
emergency contact email
emergency contact mobile
emergency contact landline
previous yoga experience (briefly)
what do you hope to gain from the workshop? (briefly)
Please let us know if you are affected by any of these. Please be in touch if you'd like to talk it over.
neck or back injury
recent major surgery
childbirth in the last 12 months
mental health condition (optional disclosure)
could be pregnant
no health condition
Please give details or add anything else you think we should know about.
Please indicate how you are paying
Payment in full required on booking. The workshop fee is transferable up to 1 week before the workshop start. You are welcome to transfer your place to a friend (no additional cost) or you can transfer onto another workshop for a £11 admin fee. Cancellation refund possible (minus 20%) if we are able to fill your space up to one week before workshop. Should we have to cancel the workshop you will be refunded in full but we cannot pay for any travel you may have bought. Each participant to complete a form, please.
internet banking FJ Law 090132 48396382 and put your name as reference
Amount paid and any notes (eg names of other people you are paying for or have paid for you)
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
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service