Traveler Profile Form
HALIFAX - COUPLES CONNECTING IN CANADA
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Gender/Pronouns
*
Passport Number
*
Passport Expiration Date
*
Passport Country of Issuance
*
Emergency contact name/contact information/relationship
*
Birth Date
*
-
Month
-
Day
Year
Date
Allergies
*
Dietary Restrictions/Preferences
*
Mobility and/or Medical Concerns
*
Health Insurance Information
*
Yoga Experience
*
Meditation Experience
*
Have you traveled with Global Sangha before? If so, which trips have you attended?
*
Submit
Should be Empty: