CONTACT
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Sound Silence Stillness Retreat
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South India Yoga Ayurveda Retreat
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Wellness
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Ayurveda
Private Classes & Counselling
Yogi's Kitchen Blog
Home
About
About Kookaburra Yoga
Calendar
Gift Vouchers Form
Retreats
About our retreats
Sound Silence Stillness Retreat
South India Devotion Retreat
Bluff Knoll Yoga & Hiking Retreat
Yoga & Cleanse 7 Day Retreat Margaret River
Bali Yogic Healing Journey
South India Yoga Ayurveda Retreat
Classes
About our Classes
Timetable
Teachers
Courses
About Our Courses
Absolute Beginners Yoga
Yoga Relax Meditate Course
Introduction to Meditation
Programs
Mohans Empowerment Through Yoga
Sound for Wellbeing with Nitya Mohan
Wellness
Yogi's Kitchen Cooking Classes
Ayurveda
Private Classes & Counselling
Yogi's Kitchen Blog
Empowerment Through Yoga Booking Form
Personal Details
*
Indicates required field
Name
*
First
Last
Email
*
Mobile Number
*
Select program attending
Option
*
2 day program $350 Early bird ($400 Full price)
Residential + Program $650 Early bird ($700 Full Price)
Camping + Program $590 Early bird ($660 Full Price)
If you are attending
public talk only
scroll down to book now
If you are attending the
5 day program
please also complete the following fields:
Gender
*
Date of birth
*
What is your reason for attending the Yogic Mindfulness Program? What would you like to achieve/learn?
*
How did you hear about the Yogic Mindfulness Program?
*
List any health issues and medications you are currently taking
*
If you selected meals specify food intolerances, allergies. All food is vegan & gluten-free.
*
Emergency Contact Person
Name
*
First
Last
Phone Number
*
Payment Options
On completing this form you will be directed to the payment page to complete the booking process and pay your initial deposit. This confirms your place.
Final steps to register
Click the
SUBMIT
button below to go to our
BOOKING PAGE
.
Please select the option to
BOOK A CLASS
Select the
YOGIC MINDFULNESS PROGRAM
on calendar
You can
pay securely
through Paypal, credit card or direct deposit.
You will receive a tax invoice and email confirmation.
Prior to the retreat you will receive an
Information Email
with details about the retreat, what to bring and what to expect. You can also find this information on our website.
Submit & Proceed to Payment
