Dolcedo Yoga Retreat Booking Form
Your place will be reserved on receipt of this completed form and your deposit payment. Please email your payment receipt and any questions to dolcedo@balmainyoga.com.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Contact telephone number (include country code)
*
Date of birth
*
Nationality
*
Emergency contact name
*
First Name
Last Name
Relationship to emergency contact
*
Email of emergency contact
*
example@example.com
Phone number of emergency contact including country code
*
Share a room?
Yes
No
If sharing, please specify who you would like to share with
Yoga Experience (7 or more years Iyengar yoga experience)
*
Please Select
Experienced Iyengar yoga student
Iyengar yoga trainee
Iyengar yoga teacher
Other
Please describe your yoga experience if not known to the teacher (years of practice, styles, etc.)
Do you have any medical conditions or injuries we should be aware of?
*
Yes
No
If yes, please provide details about your medical conditions or injuries
Do you have any dietary requirements?
*
Vegetarian
Vegan
Gluten-Free
Dairy-Free
Nut Allergy
No special requirements
Other
If Other, please specify your dietary requirements (only special diets or allergies not food preferences):
Date
*
-
Month
-
Day
Year
Date
Please agree to the following
*
I accept the terms and conditions
All the information provided above is accurate
Submit Booking
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