BIENESTAR registration

REGISTRATION FORM

BIENESTAR Study Retreat
Mancora, Peru
December 5th - 9th, 2019

* Indicates required field

CHOOSE YOUR RETREAT PACKAGE *

NAME *

First

Last

EMAIL *

COUNTRY *

PHONE NUMBER *

BIRTH DATE & YEAR *

YOGA EXPERIENCE *

FOOD PREFERENCE *

FOOD RELATED PREFERENCES OR FOOD ALLERGIES *

HEALTH CONCERNS? PLEASE SPECIFY: *

HOW DID YOU HEAR ABOUT OUR RETREAT? *

Your space will be confirmed after your full payment of the retreat package. The payment details will follow shortly. Our cancellation policy: 50% refund for all cancellations before August 31st, 2019, no refund for cancellations after August 31st, 2019. Travel and health insurances are at guest's responsibility.

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