Book Yogic Mindfulness Program

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

Empowerment Through Yoga Booking Form

Personal Details

Select program attending

If you are attending public talk only​ scroll down to book now

If you are attending the 5 day programplease also complete the following fields:

Emergency Contact Person

Payment Options

Final steps to register

yoga in harmony with nature.

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:

yoga in harmony
with nature.