Retreat Registration
We are glad that you will be part of the Astrology retreat.

After submitting your registration, you will receive a confirmation email with details for the payment.

If you need any clarification please contact us at 66 (0)84 386 0250 or sophienept1@gmail.com.
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Full Name: *
Date of birth: *
Please indicate your day, month and year.
Place of birth *
Time of Birth *
To be able to calculate your personal astrological birth chart, the time should be as accurate as possible, however an approximate time is fine.
Time
:
Home town: *
Telephone number: *
Occupation (s):
If you are in a sharing room: Name of the participant you are sharing the room with. *
If you are sharing a room with a friend, please ask her/him to fill in a form and indicate below her/his name
Do you need transportation from Bangkok to Villa du Lac? *
Do you need transportation from Villa du Lac to Bangkok? *
If you have any medical conditions that we should be aware of please  indicate them here or state "none". *
All information is treated in the strictest confidence. It is your responsibility to inform us of any physical or mental health issue which you may have or any injury recent or past. Also let us know if you are pregnant. Please update Mutsumi on arrival if applicable.
Are you on any medication? If so, please describe or state "none" *
Please let us know if you have any food allergy or intolerance or state "none": *
Are you: *
What is your tolerance for spicy food? *
Not at spicy
Extremely spicy
Any other information about your diet that Chef should know about it? *
Your yoga experience:
Please let us know if you have any animal allergy ( cat, dog, bee...) or state "none": *
How did you hear about this retreat? *
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