RETREAT REGISTRATION

OFFLINE WORKSHOP REGISTRATION

Sign-Up form for Retreat

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Name *

First

Last

Email *

Phone *

Preferred Start Date

What Time Do You Want To Start?

Preferred End Date

Which wellness retreat do you choose?

How Many people will join?

Do you have any food allergies, medication, or any other issues related to health? *

Explain Your Condition

Do you have any skin allergies? *

Explain Your skin allergies

Do you have any injuries or disease? *

Explain Your injuries or disease

Do you need pick Up Service from airport? *

(extra fee might applied)

Have you done yoga before? If yes, what levels are you at the moment? *

What's your preferred style of yoga?

Are you interested in hot yoga? *

Are you interested in wellness classes? *

Phone/whatsapp:+6281238312505
Email: contact@samadibali.com
Address: Jalan Padang Linjong 39, Canggu, Bali, 80361

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Samadi Bali

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