Perfect Balance & Down to Earth: Vietnam Retreat
February 5th - 10th & 11th - 16th, 2025 | Alba Wellness Valley, Hue, Vietnam

○ Morning meditation, daily morning and evening yoga practices, nourishing breakfast buffet and dinner, highwire adventure course & zipline, workshops and day trips included
○ Daily onsen/hot springs & 50-min reflexology or massage included (type depends on room booked)
○ 1 to 1 Reiki and Yoga Therapy sessions available on request
○ Option to stay 5 nights or 11 nights (11 night stay includes extra full-day trip between retreats)

@perfectbalanceyoga // perfectbalanceyoga@outlook.com 

@downtoearth.yogatherapy // downtoearthyogatherapy@gmail.com

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Name *
Email *
Emergency Contact Details
(Name & Phone Number, Including Country Code)  *
How many nights would you like to book?
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Which room would you like to book?  *
Would you like to share your room? If yes, do you have someone you would like to share your room with? *
Do you have any allergies or dietary restrictions?
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Do you have any injuries or restrictions which may impact movement? *
Have you had surgery within the last 6 months? If yes, please describe. *
Are you pregnant? *
Are there any other medical conditions or sensitivities we should know about in order to ensure you a comfortable stay with us?  *
CONFIDENTIALITY & GDPR
Rachel Bilski & Andrea Bertoia honour your privacy, and comply with GDPR regulations. 

We reserve the right to break confidentiality and contact the appropriate services should we consider you to be at risk of harm to yourself or to/from others. We will make every effort to discuss this with you before taking any action.

Any personal information given on this form is held securely by Rachel Bilski & Andrea Bertoia only. It will only be used for the purpose of providing a safe retreat, and will never be passed to a third-party. 

By signing this form, I consent to my information being used in this way.
DISCLAIMER & DECLARATION
By signing this form, I confirm that to the best of my knowledge all the information provided in this form is accurate and up to date. I understand that yoga is a practice which involves physical movement, breathing, and meditation, which induces specific physiological and psychological changes. I represent that to the best of my knowledge and belief I am able to participate in these aforementioned activities. 

In the event that I am unsure or if I have questions regarding these practices I will speak to my doctor and Rachel Bilski or Andrea Bertoia to receive further counsel and will follow their advice.

I understand that this yoga retreat involves movement and optional adventure activities, and in the unlikely event that injury occurs, I will not hold Rachel Bilski or Andrea Bertoia liable. I hereby assume full responsibility for any risk or injury, arising out of or related to my participation and or instruction in the retreat, and will take responsibility for any relevant insurance I may require.

I understand that my booking requires a 15% non-refundable deposit to secure my place, and that the final balance is also non-refundable once paid. 

I understand that I am responsible for notifying Rachel Bilski or Andrea Bertoia of any changes to my health or medical conditions that may affect my participation in the retreat.
I AGREE TO THE ABOVE GDPR STATEMENT & DISCLAIMER
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