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Registration Form
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Welcome to the registration form for the Bali Retreat with Dave Stringer and Alanna Kaivalya. Please fill this out to the best of your ability.
Your Name:
*
Your Email:
*
Confirm Email:
*
Home Address and Country:
*
Preferred Phone Number:
*
Occupancy:
*
Shared room/single bed
Single room/king bed
Expected Arrival Date:
Expected Departure Date:
Have you been to Bali before?
*
Yes
No
Yoga Experience:
*
Beginner
Intermediate
Meditation Experience:
*
Beginner
Intermediate
Advanced
Chanting Experience:
*
Beginner
Intermediate
Advanced
Are you a vegetarian?
*
Yes, but I eat dairy and/or eggs
Yes, and I'm a strict vegan
Sort of, I eat fish, too.
Do you have any allergies?
*
Do you have any physical limitations?
*
Special Requests:
We will confirm the receipt of your registration form and be in touch with you within 48 hours. Thank you!
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