Booking form: workshops at Viveka Gardens 2020

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Om! We're looking forward to hosting you at Viveka Gardens.
This information is for contractual purposes and for emergency and health reasons. It will be retained for 2 years on the google cloud and then deleted. Please see our Privacy Policy at vivekagardens.com for more information and how to opt out.
Please complete this form and make your payment (see the end of the form). See you soon. Om Shanti.

Email *

name *

mobile and/or landline (both preferred)

Name and date of workshop

see the website for yoga and nidra day retreats vivekagardens.com

Other:

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How did you hear about Viveka Gardens or this workshop

search engine

facebook posting

facebook promotion

word of mouth

flyer or poster

Other:

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If you would like to receive the newsletter please opt in here http://eepurl.com/bnDb4X *

I send a monthly newsletter and sometimes special offers

landline

emergency contact *

emergency contact email *

emergency contact mobile *

emergency contact landline *

previous yoga experience (briefly) *

what do you hope to gain from the workshop? (briefly) *

Please let us know if you are affected by any of these. Please be in touch if you'd like to talk it over. *

heart condition

diabetes/glaucoma

neck or back injury

osteoporosis

recent major surgery

childbirth in the last 12 months

depression, grief

mental health condition (optional disclosure)

could be pregnant

no health condition

Other:

Please give details or add anything else you think we should know about. *

Please indicate how you are paying

Payment in full required on booking. The workshop fee is transferable up to 1 week before the workshop start. You are welcome to transfer your place to a friend (no additional cost) or you can transfer onto another workshop for a £11 admin fee. Cancellation refund possible (minus 20%) if we are able to fill your space up to one week before workshop. Should we have to cancel the workshop you will be refunded in full but we cannot pay for any travel you may have bought. Each participant to complete a form, please.

internet banking FJ Law 090132 48396382 and put your name as reference

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Amount paid and any notes (eg names of other people you are paying for or have paid for you)

I agree to take full responsibility for myself and for my personal property. The decision to participate in the activities is my own responsibility. In addition I agree that I will not hold Viveka Gardens responsible for any injuries or damages that might result from my participation in any of the activities. 'Sign' by typing your name and date

Send me a copy of my responses.

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