GUEST BOOKING FORM

Please note, retreat places can only be confirmed when proof of payment is advised. If you have any questions regarding payment, including payment plans, please get in contact - we are always happy to discuss your needs. Once we have received and reviewed your booking form, we'll send an invoice including a payment link.

With love and gratitude, Team Chaya.

Name

First Name

Last Name

Retreat title and location

Which room option would you like?

Date of birth

YYYY

What is your profession?

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone number with area code

Your website

http://

Instagram

Food allergies, likes, dislikes

What is your level of movement practice experience and what do you practice?

Do you have any health issues you may like to address through the retreat?

What would you like to transform, heal, experience or manifest through being on retreat with us?

Where did you hear about the retreat?

Name and contact details of next of kin

Checkbox

I am over 18

I accept the terms and conditions (please find link at the bottom of the home page)

Any other message for our team, or anything you'd like to share?