Pilgrimage to India & Nepal: Walking with the Buddha 2020 Registration
You can download a copy of the contract for your records at https://goo.gl/EoCwk6
Sign in to Google to save your progress. Learn more
Full Name (Please write it *exactly* as written in your Passport) *
Preferred name (or nickname)
Date of birth (month, day, year, in that order) *
MM
/
DD
/
YYYY
Complete Home Address (please include street address; city; state; ZIP code and country if outside the USA) *
Best phone number to reach you *
Just in case we need to get ahold of you more quickly than via email in an emergency only. Please include the country code if outside the USA or Canada.
Email address *
Please know that we rely solely on email to keep you updated about trip information. Please provide the best email address for you, and make sure we are added to your address book to avoid our emails going to your spam folder.
Passport country of issue *
Expiration date of passport *
Important note: Your passport must have at least six months validity from the end of the trip and at least two blank pages in it.   If you wish to register for this trip but have an expired or soon-to-be-expired passport, you can still enter your old passport info and we will update it when you send us the new information.
MM
/
DD
/
YYYY
Will you have a single room or a shared room on this trip? *
If you are willing to share but don't have a roommate already, we can let you know if others are in a similar situation. However, we can't guarantee that you will have a roommate.
If you are sharing a room, what is your roommate's name?
Occupation & Interests: Please tell us more about you so we can make sure you get the most out of your time with us!  We can help find little gems along the way that are in line with your interests. *
Emergency contact information *
Please include: Name, relationship, their phone number and an email address
Food allergies (gluten, dairy, etc) / Dietary restrictions (vegetarian, vegan, etc)
Do you have any health conditions and/or severe allergies (food, drug, or environmental) we should be aware of? Do you use any medications you will need refrigerated or medical devices that require electricity?
Briefly describe your meditation practice.
What are you hoping to experience on this journey?  How can we help you get the most out of your time with us? *
I understand that travel insurance is mandatory on this journey. *
You can see details about what is required at www.RetreaTours.com/travel-insurance
Required
How did you first learn about this trip? *
Please read and sign the Tour Contract and Liability Waiver below.
I agree to the Tour Contract and Liability Waiver *
Required
Please sign below with your digital signature which consists of your full name *
Example:  John Q. Sample
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy