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HIGH VIBE YOGA

Ready to shake things up? This yoga is a way of life.

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50HR Women’s SelfCare Application

Name *

First

Last

Email *

Phone (please include country code) *

Name you wish to print on your certificate *

Date of Birth DD/MM/YY *

Passport Number *

Nationality on Passport *

If you are currently outside of your country of birth, please share where and what has brought you there. *

Emergency Contact Name *

Relationship *

Email *

Phone (please include country code) *

How did you first hear about High Vibe Yoga? *

If refferred, by whom? *

Is this your first training or retreat experience?* *

Yes
No

What interests you about the offerings in our 50 Hour Women's Self-Care Training? *

Choosing to be part of this Intensive means that you are willing to go very deeply into your process and expansion! There is so much support for this and we know it will be a beautiful time together. Do you have any physical or emotional health conditions that could affect your participation in the training or that we should be aware of? *

Do you have any medical conditions that may need attention during the training? Please list any medications you will be taking during the training. *

Diet: vegan, vegetarian, gluten free, dairy free, etc. *

Please list all food allergies: *

Please select your room & rate *

Deluxe King (private) $2,260.00 USD
Simple Single (private) $2,040.00 USD
Deluxe Twin (2 pax, 2 single beds) $1,990.00 USD
Deluxe Triple (3 pax, 3 single beds) $1,880.00 USD

(SHARE ROOMS) Do you have a preference whom you room with? *

CANCELATON & REFUND POLICY *

I agree to the following terms: *

I understand the $500 Deposit is non-refundable, unless I am not accepted to the course
I understand the final payment balance is due in full by December 15th, 2020
I have read and accept the Cancelation / Refund Policy
I will complete the Facebook tasks, prior to the program