Simon Yoga retreats booking

When you have filled the booking form - to book right away then click on purchase button. If you wish to only make an enquiry then click submit without paying.

Please note that the option without payment does NOT reserve you a place. Payment secures a reservation and places go fast!

I wish to purchase my place

PURCHAS E

Booking form

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

E-mail Address*

Street Address*

City*

State/Prov*

Zip/Postal Code*

Country*

Home Phone*

Business Phone

Fax

I want to book/am interested in the following retreat/holiday. *

	SPAIN - 21st-28th June Yoga, Walking and Detox with Simon, Rumana.
	Single room supplement (£99pw)
	Transfer £20single/£35return
	SPAIN - Yoga+mosaic in Spain

I have paid:*

	A deposit of £200.00 - detox+yoga holidays
	A deposit of £100.00 - yoga mosaic holidays
	The full amount - £826.00 - Detox Spain
	Full amount - £618.00 Yoga Mosaics Spain
	Nothing yet (and realise that no place is secure until full payment is received)

For how many?*

	1
	2
	3
	4
	5
	6
	7
	8
	9
	10

Please specify*

	Male
	Female

Date of Birth*

Special/Medically prescribed diets*

If pregnant please state no. of weeks*

Are you a :*

	Smoker
	Non smoker

Rooms: based on sharing*

	Twin/Triple
	Single (very few first come basis)

Please state if you would like to share with a friend and gives Name(s)*

How did you hear about this retreat?*

Please state in and out travel arrangements - flight times and numbers or put "To be decided"*

Do you require coach transfer:*

	Both ways
	One way from Malaga
	One way from Orgiva
	Making your own way (describe below)
	Not applicable for Yoga+Mosaic bookings

I am making my own way there as described below:*

Please tick any therapies you might like whilst there (optional) - tick N/A if yoga mosaic hols*

Please tick any therapies you might like whilst there (optional)*

	Massage
	Reflexology
	Reiki
	Astrology
	Consultations with Rumana
	Not applicable

Please tick below to state that you have read all the booking conditions and terms and understood and accept them*

I acknowledge this as my electronic signature and acceptance of booking terms and conditions

Any other questions?

	Yes, sign me up
	Not at the moment, thanks

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