Mind, Body, Spirit Booking Form
Please provide us with your contact information below. A minimum 30% deposit is required to secure your booking.
Name
*
First Name
Last Name
Email
*
Mobile Number
*
Address
*
Street Address
City
State / Province
Postcode
Emergency Contact Details
Name
*
First Name
Last Name
Mobile Number
*
Please list any medical concerns we should be aware of?
Package & Payment
Please select ONE payment option below. Your reservation WILL NOT be secured unbtil a deposit has been received. Please read T&Cs on full cancellation and booking terms.
Free Retreat Singlet Size
*
Please Select
Womens - XSML
Womens - SML
Womens - MED
Womens - LGE
Womens - XLGE
Retreat Package
*
1. Deluxe - Pool Room (SOLD OUT)
2. Deluxe - Spa Room (SOLD OUT)
3. Private Bathroom
4. Shared Bathroom
5. Single Room
Payment Method
*
Credit Card (do it yourself)
Pay Over Phone (we call you)
When is the best time for us to call?
Please Select
Anytime
Between 9am - 5pm Weekdays
After 5pm Weekdays
Weekend
Payment Options
*
Upfront Payment
Deposit Now + One Final Payment
Deposit Now + Monthly Payment Plan
Credit Card Payment
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3. Private Bathroom
Price listed is FULL package price
$
3,190.00
AUD
3. Private Bathroom
Price listed is 30% Deposit Only | Total Package Price $3,190
$
957.00
AUD
4. Shared Bathroom
Price listed is FULL package price
$
2,890.00
AUD
4. Share Bathroom - Deposit Only
Price listed is 30% Deposit Only | Total Package Price $2,890
$
867.00
AUD
5. Single Room
Price listed is FULL package price
$
2,890.00
AUD
5. Single Room
Price listed is 30% Deposit Only | Total Package Price $2,890
$
867.00
AUD
Credit Card
Signature
*
Date
*
-
Day
-
Month
Year
Date
Take me to Thailand!
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