"Radiance comes from
within, manifesting as
shining skin, hair and
eyes. Radiance Retreats
are a complete renewal
of body, mind and spirit"

radiance - n. 1.
the quality or state of
being radiant
radiant - adj. 1.
characterized by health,
intense joy,
adj. 2.
sending out rays of light;
bright; shining
retreat - vb. 8.
a place to which one may
retire for refuge, quiet, etc...


BOOKING & ENQUIRY FORM

RADIANCE BYRON BAY YOGA CLEANSE WALK RESTORE RETREAT
Friday 6th -Wednesday 11th September 2019
5 night all-inclusive retreat

Once this form is submitted you'll have the option to pay your deposit online, which confirms your booking, or to wait to receive our email with more retreat information.

*use the mouse or tab key to move to the next item, as the enter key will send the form before it is completed

Name:

Email: (required). *only insert one email address

Address:

Phone:

Additional Home or Work Contact Number (if applicable):

Age:

Gender:

Occupation (optional):

PLEASE TELL US...

Have you been to a Radiance Retreat before?
Yes

If so where:

Would type of room would you like?


Single Room with own bathroom (between 2 rooms) - AUD $2,115

Standard Single Room with own bathroom - AUD $2,245

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Please tell us your reason/s for joining this retreat and what you're hoping to get out of this time:

Please tell us your yoga practice history (if any). For example: how many years you've been practicing; what style/s of yoga (if known); are you a yoga teacher, etc:

Please detail any injuries, medical conditions, allergies, etc, that you may have.
If pregnant include the trimester you'll be in during the retreat.

Do you have any special dietary requests or foods you are allergic to?

Anything else we should know about?

Emergency contact name:

Emergency contact number:

Where did you find out about us? Please tick appropriate box below or fill in the 'other' section





(please name the publication in box below)


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