GIFT CERTIFICATE FOR PRIVATE GROUP BREATHWORK

GIFT CERTIFICATE FOR PRIVATE GROUP BREATHWORK
Your Name*

First NameLast Name
Your Email*
Recipients Name*

First NameLast Name
Recipients Email*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Recipients Phone Number*
Please enter a valid phone number.
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment Options*

Cash or Check (preferred)Credit Card
Group Breathwork Prices:
1-3 people = $250
4-7 people = $350
8-12 people = $450
13-20 people = $750
21-25 people = $1,200

Additional Time:
30 Minutes = $50
60 MInutes = $100

Travel Fee:
0-15 Minutes (round trip) = $0
15-30 Minutes (round trip) = $15
30-60 Minutes (round trip) = $30
60-90 Minutes (round trip) = $45
90-120 Minutes (round trip) = $60

Select the appropriate number of people for your group event.*

Group Breathwork (1 hour)

$250.00

Additional Time

$ Free
Item subtotal:$0.00

Travel Fee

$ Free
Item subtotal:$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Owners Signature*

Clear
Should be Empty: