Yoga Retreat Registration form

Yoga Retreat Registration form

Dune Lakes Lodge - Auckland, New Zealand

6th-8th December 2024

Register here

Name

First Name

Last Name

Age

Email

Phone number

Country

(###)

###

####

Emergency contact name

Emergency contanct number

Country

(###)

###

####

Which room are you booking?

Dormitory

Please describe your reasons for coming to the retreat

Are you currently taking any prescribed medication? If yes, please discribe

Have you recently experienced any major stressors? If yes, please describe

Do you have any health issues we should know about?

Do you have any dietary requirements? Please state

Is there anything else you think we should know?

Where did you hear about the retreat?

Checkbox

I accept the terms and conditions including the cancelation policy stated under "More Information" in the retreat's page

Yes

Payment information will be sent to your email address.

See what Mariana’s clients say here.