Journey Home Women's 4-Day Retreat Booking Form

The Journey Home Women's Retreat Booking Form

Personal Details

* Indicates required field

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Mobile Number *

Gender *

Date of birth *

If you are attending with a friend/partner you'd like to share with please enter their name *

Accommodation

Select accommodation option for 4-Day Women's Retreat *

$1090 Twin share room ONSITE (pp) $1690 Single Luxury Apartment ONSITE (pp) $2690 Couple Luxury Apartment ONSITE (2 ppl) $1290 Single Room OFFSITE (pp) $1190 Twin share room ONSITE (pp) - 6-Month Payment $1790 Single Luxury Apartment ONSITE (pp) - 6-Month Payment Plan $2790 Couple Luxury Apartment ONSITE (2 ppl) - 6-Month Payment Plan $1390 Single Room OFFSITE (pp) - 6-Month Payment Plan

List any allergies, food allergies/intolerances and dietary considerations *

List any health issues and medications you are currently taking *

Any Comments/Notes *

Emergency Contact Person

Name *

First

Last

Phone Number *

Payment Options & Instructions

Pay deposit when booking and balance prior to retreat

On completing this form you will be directed to the payment page to complete the booking process.
As part of the booking process you'll be directed to pay your deposit of $400 per person. This confirms your place.
You'll receive an invoice for the balance prior to the retreat.

Final steps to register

Click the SUBMIT button below to go to the PAYMENT PAGE.
Please select the option to BOOK A CLASS
Select the retreat option above and retreat date on calendar
Follow the prompts to pay your deposit
If you've opted for a Payment Plan please pay your deposit and then send us an email to info@kookaburrayoga.com. Payment plans incur an additional cost of $100.
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