MOTHER AND CHILD RETREAT

REGISTRATION FORM - BALI, 2018

Thank you for registering for the 2018 Mother & Child Retreat in beautiful Bali, Indonesia! We are thrilled to be whisking you away on this adventure. Here

are your next steps to get going...

Step 1 - Complete the Registration Form below and agree to Terms & Conditions

Please note personal data is strictly confidential and will only be used for retreat design.

Step 2 - Select Accommodation and extras

Step 3 - Make 50% Deposit

STEP 1: REGISTRATION FORM

Name

First Name

Last Name

Email Address

Mobile

Country

(###)

###

####

Date of Birth

MM

DD

YYYY

What is your child(ren)’s name?

If you are bringing two children please state both names

How old will your child(ren) be at the time of the retreat?

If you are bringing two children please state both ages

Terms & Conditions

View TERMS & CONDITIONS here

Yes, I have read and agree to the Terms & Conditions