Retreat Booking Form Name* First Last Email* Phone*Address* Street Address City ZIP / Postal Code Emergency Contact Details*Please provide their name, contact number and relationship to you.Do you have any injuries or health conditions that may affect your participation in this Retreat?* Yes No If yes, please provide further information below:Please note: this information is solely for the use of the teacher and will be kept confidential.Payment* I would like to book into a Bunkroom, pay a deposit of $240 and the balance of $235 by April 1. I would like to book into a Bunkroom and pay the full amount of $475. I would like to book into a Studio, pay a deposit of $240 and the balance of $285 by April 1. I would like to book into a Studio and pay the full amount of $525. I would like to book into an Apartment, pay a deposit of $240 and the balance of $335 by April 1. I would like to book into an Apartment and pay the full amount of $575. Fees must be paid by electronic transfer. The bank details will be sent to you after you register. Thank you. Cancellation Policy* I have read, understand and agree to the Cancellation Policy below. Refunds are available if one cancels by April 1 and will incur a $60 processing fee. No refunds are available after April 1, 2025 unless we are able to fill your place from a wait-list.Terms & Conditions* I have read, understand and agree to the Waiver below. I ackowledge the inherent risks associated with any physical exercise. I accept those risks and enter this Retreat freely of my own decision. I will hold no-one (including Manaia Yoga & Wellbeing or Melissa Gardiner) to blame for any injury, whether physical or mental arising out of my attendance at the Retreat, associated exercises, following of any printed literature and use of the premises. Would you like a receipt e-mailed to you?* Yes please No thank you Manaia's Mailing List* Please sign me up to Manaia's Mailing List (bimonthly newsletters) so I am kept in the loop about Melissa's events, classes, expos and wellbeing services. I am already regsitered on the Manaia database to recevied the bimonthly newsletters, thank you. Any comments or queries...Yoga Props*Yoga props include: bolsters, blankets, eye bags, belts and blocks. Please list above what you have or what you need. Thank you.