Skip to content
PHONE: 0403 135 342
Radiance Yoga Wellness Retreats
with Jessie Chapman & facilitators
HOME
ABOUT
RETREATS
BYRON BAY RETREATS
NEW ZEALAND RETREATS
BALI RETREATS
PYRENEES RETREATS
SPAIN RETREATS
GUEST REVIEWS
CALENDAR
CLASSES
BYRON BAY YOGA CLASSES
ONLINE YOGA CLASSES
STORE
RADIANCE SHOP
RETREAT PAYMENTS
CONNECT
CONTACT US
NEWSLETTER SIGNUP
ARTICLES & MEDIA
Bali Retreat Registration Form
Please enable JavaScript in your browser to complete this form.
Which Bali Retreat date are you registering for?
*
June 16th - 22nd 2025 > Bali Yoga Spa Restore Wellness Retreat
June 24th - 30th 2025 > Bali Yoga Spa Restore Wellness Retreat
August 16th - 22nd 2025 > Bali Yoga Spa Restore Wellness Retreat
Your Name
*
First
Last
Email
*
Confirm your email
*
Have you been on a Radiance Retreat before? If yes, whereabouts?
What room type would you like to stay in?
Twin Share Room with ensuite bathroom
Single Room with ensuite bathroom
If selecting Twin Share: enter the person you're sharing with OR type 'choose for me'
Country & state/region where you live
Your contact number
Age or year of birth
Gender
Emergency contact: name & number
Occupation (optional)
List any injuries, physical conditions, allergies or medical conditions, etc that we need to be aware of
Meals: Do you have any food allergies, food intolerances or other dietary requests?
Yoga: Are you new to yoga? Have a regular practice? If so, what style of yoga do you practice (if known). Let us know more here
We'd love to know your reason/s for joining the retreat; what you'd like to experience / get out of the retreat
Anything else you feel we should know about?
Where did you find out about Radiance Retreats
Word of Mouth / Friend
Jessie's Yoga Books
Radiance Yoga DVDs
Internet Search
Radiance Facebook, Instagram or YouTube Channel
Other (let us know in the box below)
Other / how you found out about the retreat
Tick 'Yes' to be added to the Radiance Retreats Newsletter
Yes
Submit
