Retreat Application

Application Form:

* Indicates required field

Name *

First

Last

Date of Birth *

Email *

Telephone no. *

Retreat Date *

Accommodation Options (for in person courses) *

'WUB' Converted Truck Glamping Pod Own Tent Own Campervan

Have you practiced yoga /meditation before? *

Any Physical or Mental Health Issues/ Dietary or Special Needs (All meals are vegan, we will try to accomodate your needs but cannot guarantee): *

Emergency Contact *

First

Last

Relationship to yourself *

Emergency Telephone no. *

Which Payment Tier Are You? *

Tier 1 Tier 2 Tier 3

Discount Code *

T&C's *

Tick here to confirm that you have read and agree to our terms and conditions (see below)

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A £150 deposit is payable within 5 working days of booking

Address *

Line 1

Line 2

City

State

Zip Code

Country

I agree to receiving marketing and promotional materials

Submit