Formulir Pendaftaran Medical Wellness

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Formulir Pendaftaran Medical Wellness

1. Nama Lengkap :

2. Alamat Lengkap :

3. Nomor Whatsapp aktif :

4. Pilihan Paket :

Ayu Anaya (Rp. 1.238.000,-)

Ayu Lakshita (Rp. 1.385.000,-)

Ayu Argya (Rp. 1.379.000,-)

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5. Pilihan Produk - (Medical) :

General MCU – termasuk snack & makan siang (Rp. 553.000,-)

MCU khusus pria atau wanita – termasuk snack & makan siang (Rp. 718.000,-)

Mental Health Check-up – termasuk snack & makan siang (Rp. 608.000,-)

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6. Pilihan Produk - (Wellness) :

Estetika (Rp. 200.000,-)

Atsiri Jawa Enyet Pamidhangan & Madushita (Rp. 290.000,-)

Racik Raksi Body Oil & Madushita (Rp. 250.000,-)

Pada Pamidhangan & Madushita (Rp. 350.000,-)

Hortus Garden Tour (Rp. 12.000,-)

Accupresure (Rp. 46.000,-)

Akupuntur (Rp. 95.000,-)

Meditasi/ yoga (Rp. 49.000,-)

Herbal learning (Rp. 63.000,-)

Healthy food learning (Rp. 28.000,-)

Project class ecoprinting (Rp. 50.000,-)

Project class pot pourri (Rp. 65.000,-)

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7. Pilihan Hotel :

Nava Hotel Tawangmangu Superior room & Breakfast 2 pax (Rp. 1.200.000,-)

Nava Hotel Tawangmangu Deluxe room & Breakfast 2 pax (Rp. 1.400.000,-)

Atsiri Citronella Room & Breakfast Special Rate Weekday (Monday s/d Thursday) (Rp. 1.560.000,-)

Atsiri Citronella Room & Breakfast Special Rate Weekend (Friday s/d Sunday) (Rp. 1.730.000,-)

Atsiri Palmarosa Room & Breakfast Special Rate Weekday (Monday s/d Thursday) (Rp. 2.000.000,-)

Atsiri Palmarosa Room & Breakfast Special Rate Weekend (Friday s/d Sunday) (Rp. 2.200.000,-)

Atsiri Marigold Room & Breakfast Special Rate Weekday (Monday s/d Thursday) (Rp. 2.080.000,-)

Atsiri Margold Room & Breakfast Special Rate Weekend (Friday s/d Sunday) (Rp. 3.150.000,-)

Atsiri Rosemary Room & Breakfast Special Rate Weekday (Monday s/d Thursday) (Rp.2.520.000,-)

Atsiri Rosemary Room & Breakfast Special Rate Weekend (Friday s/d Sunday) (Rp. 3.150.000,-)

Hortus Inn Standar Twin Bed & Breakfast (Rp. 250.000,-)

Hortus Inn VIP Double Bed & Breakfast (Rp. 300.000,-)

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8. Tanggal Reservasi :

9. Pilihan Transportasi :

Avanza (mobil + sopir : Rp. 400.000,-/hari)

Avanza (mobil + sopir : Rp. 500.000,- (inap)/hari)

Inova (mobil + sopir : Rp. 600.000,-/hari)

Inova (mobil + sopir : Rp. 700.000,- (inap)/hari)

Hi ace (mobil + sopir + BBM + menginap : Rp. 1.300.000,-)

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