"Radiance comes from
within, manifesting as
shining skin, hair and
eyes. Radiance Retreats
are a complete renewal
of body, mind and spirit"

radiance - n. 1.
the quality or state of
being radiant
radiant - adj. 1.
characterized by health,
intense joy,
adj. 2.
sending out rays of light;
bright; shining
retreat - vb. 8.
a place to which one may
retire for refuge, quiet, etc...


BOOKING & ENQUIRY FORM

2018 NOVEMBER NEW ZEALAND YOGA HIKE RESTORE RETREAT
Tue 27th November - Sun 2nd December 2018

Note: use the mouse or tab key to move to the next item, as the enter key will send the form before it is completed.

Name:

Email Address: (required)

(the system will only accept one email address)

Address:

Phone (Mobile):

Additional Home or Work Contact Number (if applicable):

Phone (Home):

Date of Birth:

Gender:

Occupation (optional):

PLEASE TELL US...

Have you been to a Radiance Retreat before?
Yes

If so where:

Would type of room would you like?



Please tell us your reasons for taking the retreat and what you're hoping to get out of it:

Please tell us your yoga practice history (if any); how many years you've been practicing; what style/s of yoga (if known); etc:

Please detail any injuries you may have; any illness or medical conditions, any allergies or if you are pregnant::

Do you have any special dietary requests or foods you are allergic to?

Anything else we should know about?

Emergency contact name:

Emergency contact number:

Where did you find out about us? Please tick appropriate box below or fill in the 'other' section





(please name the publication in box below)


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