Registration Form for RetreaTours

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Which trip are you registering for? *

Please list the instructor's name (if applicable) and dates of the trip

Full Name (Please write it exactly as written in your Passport) *

Preferred name (or nickname)

Date of Birth *

YYYY

Home Address (please include street address; city; state; ZIP; country) *

Best phone number to reach you *

Just in case we need to get ahold of you more quickly than via email!

Email address *

Passport country of issue *

Passport number *

Expiry date of passport *

Please know that to enter most countries a passport must have at least six months validity and at least two blank pages

YYYY

Will you have a single room or a shared room on this trip? *

If you are willing to share but don't have a roommate already, we can let you know if others are in a similar situation. However, we can't guarantee that you will have a roommate.

I have a roommate but want separate beds

I have a roommate and will share a bed

I do not want a roommate and will pay the single supplement

I do not have a roommate but would like a roommate (though I understand if a roommate cannot be found I will have to pay the single supplement)

If you have a roommate, do you prefer one big bed or two separate beds?

1 big bed

2 separate beds

Doesn't matter

Clear selection

If you are sharing a room, what is your roommate's name?

Hobbies/Interests/Occupation; we'd love to know a little about you and this will also help us suggest activities and sites for you. *

If you are attending a Bali/Lombok retreat, please let us know if you are a diver.

Emergency contact information *

Name; Relationship; Phone Number; Email

Food allergies (gluten, dairy, etc) / Dietary restrictions (vegetarian, vegan, etc)

Any health conditions/allergies (food, drug, or environmental) we should be aware of? Are there any medications you will need refrigerated?

How long have you been practicing yoga? Briefly describe your yoga practice. (Only for yoga trips!)

Any injuries or trouble spots the yoga instructor should know about? (Only for yoga trips!)

What are you hoping to experience on this RetreaTour™? How can we help you get the most out of your time with us? *

Please read and sign the Tour Contract and Liability Waiver below

I agree to the Tour Contract and Liability Waiver *

I agree

Required

Please sign below with your digital signature which consists of your full name *

Example: John Q. Sample

Submit

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