Journey to Wholeness Registration Form

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Thank you for your interest in our Journey to Wholeness Retreat, scheduled for 17-23 Feb 2023 in Bali. Please fill in the details below to the best of your ability, which will help us serve you better.

A confirmation email and payment details will be sent upon review.

If you are coming in a pair or a group, please fill out the form for each participant and indicate that you are coming as a pair/group under the message section. This will help us arrange your stay together.

We look forward to seeing you soon.

- Yoganga Healing and SOMAYOKE

Name *

First and last name

Email *

Phone number *

Date of Birth

YYYY

Gender

Male

Female

Clear selection

Country of Residence

Occupation

Preferred room type during the retreat *

Room in shared bungalow (Sharing with 2 other people) [Price SGD $1400]

Room in shared bungalow (Sharing with 1 other person) [Price SGD $1600]

Single occupancy [Price SGD $1800]

Why would you like to attend the retreat? *

Any medical issues you'd like us to know

Message (anything else you'd like to let us know)

Submit

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