Wellness Retreat Booking Form

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Which style of accommodation would you like to book?

Your Details

Your First Name

Your Last Name

Your Email

Contact Number

If you would like to share your room with someone you know coming on the trip, please specify their name below.

Would you like to add optional extras?
Foot Spa/Soak/Tea Ceremony $155 plus GST) Positive Energy Life Course (50% off) for only $97

Do you have any pre-existing injuries or medical conditions?
yes no

Please provide details

Do you have any allergies or dietary requirements?
yes no

Dietary Requirement Details

Have you read, and agree to the Booking Terms & Conditions?
yes

Do you have a discount code? Enter it here, and we'll take the discount amount off your final invoice.

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