Luxury Yoga Health Retreat

Please use this form to check availability. Although the availability is updated daily it might be that a retreat is no longer available. We recommend you to book your flights only after we confirm your booking

Please select your options:

Retreat in Ubud schedule for 2012 on:

May 13 - 18, 2012
June 10 - 15, 2012
July 15 - 20, 2012
August 19 - 24, 2012

* Although the availability is updated daily it might be that a retreat is no longer available. Please use this form to check availability.

Occupancy

Single Occupancy Twin Share (1 bed) Twin Share (2 beds)

If you are sharing a room, what is the name of your room mate?


Please note: Each participant must fill this registration form separately.

Personal Information

• First Name
:
*


• Family Name
:


• Home Address
:


• Country
:
*


• Home Telephone Number
:
*


• Office Telephone Number
:


• Mobile Phone Number
:


• E-mail address
:
*


• Re-enter your email
   address
:
*


• Arrival Flight Date
:
   


• Arrival Flight Details to Bali
:
Airline :      Flight #


• ETA (estimated time
   arrival)
:


• Departure Flight Date
:
   


• Departure Flight details
   from Bali
:
Airline :      Flight #


• ETD (estimated time
   departure)
:


• Will you stay with us prior
   to the retreat?
:
Yes No


• If yes, date of arrival at
   ONEWORLD retreats -
   Kumara
:
   


• If no, where will you stay
   prior to the retreat?
:


• Telephone number of your
   accommodation prior to the
   retreat? (if apply)
:


• Will you stay with us after
   the retreat?
:
Yes     No


• If yes, date of departure
   from ONEWORLD retreats -
   Kumara
:
   


• If no, where will we take
   you after the retreat?
:


• Have you been to Bali
   before?
:
Yes No


• Have you attended one of
   our retreats before?
:
Yes No


• Your Birthday
:
   


• Yoga Experience
:


• Type of Yoga
:


• Do you practice meditation
   on a regular basis?
:
Yes No


• Have you practiced
   meditation in the past?
:
Yes No


• Meal Preferences

   (please note that we do not
   serve red meat or pork)
:
I am a vegetarian
I am a pescetarian, (I am a vegetarian but
      eat fish)
I am a vegan (I don’t eat any meat, eggs,
      dairy products)
I have none of the meal preferences above


• If you have any other meal
   preferences, please let us
   know:
:


• Please explain if you have
   any physical disorder that
   we should be aware of
   Because of the activities included
   in the retreat an average level of
   health and fitness is required.


:



• Special Request
:


How did you hear about us? (Please be specific e.g. Google, website, magazine, friend's name etc.)
:


CONSUMER DISCLOSURE NOTICE


I have read and agree to the Consumer Disclosure Notice

We will confirm your reservation within 36 hours.