2010 PERSONAL RETREAT Registration
Please complete a registration form for each person.
All fields with * must be filled out in order for this form to be submitted to us.
 

1. Dates Attending:   (Please refer to our online calendar for available dates)
* Date:     to
 
2. Personal Information:
* Full Name:             Gender:    
* E-Mail:      
Phone (Day):      
Full Address:      
 
3. Emergency Contact Information:
Contact Name / Relationship:      
Contact Phone:      
Contact E-Mail:      
 

4. How did you hear about us? *  (please specify)  

 
5. We offer a lacto-vegetarian yogic diet. While we do our best to provide options for various diets, we cannot guarantee this. Please list any dietary restrictions:  

 

6. Fees:   Rates are per person per night and include accommodation, all facility usage, vegetarian meals, tea bar, and any scheduled yoga classes. The shared accommodation rate for personal retreats will only apply if you are registering with a friend. In that case, please enter your friend's name here:

Accommodation (per person per night) Wait-list if not available?
First Choice:   No     Yes
Second Choice:   No     Yes
Third Choice:   No     Yes

 

7. Bodywork treatments: Interested in receiving a treatment at our on-site Ayurveda wellness centre? We recommend booking at least two weeks in advance to ensure the best availability. For more information or to book an appointment, contact us 250.537.8443 or chikitsashala@saltspringcentre.com.

8. PAYMENT METHOD:     PayPal    Credit Card (By Phone)    Personal Cheque / Money Order

All fees must be paid in full to hold your reservation. Rates are quoted in Canadian dollars and include all applicable taxes.

If you select PayPal as your payment method, a PayPal invoice will be emailed to you. If you wish to phone in your credit card information, please call us at 250.537.2326. Your credit card number will not be kept in our files subsequent to processing your payment. Please do not under any circumstances send your credit card information by e-mail. We also take Canadian or US cheques and/or money orders. Payments in US funds will be credited toward program fees at the prevailing exchange rate.

8. CANCELLATION POLICY:   *     I have read the Salt Spring Centre's Cancellation Policy for Personal Retreats and agree to its terms.  

   


 

The Salt Spring Centre of Yoga
355 Blackburn Rd., Salt Spring Island, BC, Canada V8K 2B8 Phone: 250.537.2326   Fax: 250.537.2311 
Email: yoga@saltspringcentre.com