First Name

Last Name

Birthdate (Day/Month/Year)

Email Address

Available Retreats

Package Choice

Traveling with a friend? If so, please list their name.

(Each person traveling needs to fill out a form)

Mailing Address

Home Phone

Cell Phone

Your Occupation

Emergency Contact Name and Phone number

I am new to surfing (Beginner - I would like to learn the fundamentals of surfing)

I am learning to surf (Novice - I have surfed a few times in small conditions and need to be pushed on to waves)

I have a surfing foundation (Intermediate - I do not need to be pushed onto waves and want to start working on maneuvers)

I am an experienced surfer (Advanced - I am confident surfing in all conditions and wish to refine maneuvers)

How many years have you been surfing?

How many times a year do you surf?

What size waves and board do you prefer to ride?

Please describe your yoga experience (if any)...

Will you require an airport transfer or hotel transfer on the first day of the retreat?

Would you like assistance planning extra time in Bali pre or post the retreat?

List any allergies, medical conditions, special dietary requirements or anything else we need to be aware of?

Retreat Goals - What would you most like to get out of the retreat?

I would like to pay by

How did you hear about us? (Please be specific e.g. Google, guide book, magazine, friend's name etc.)

Our Process
After you have sent in your completed reservation form, and we have confirmed availability on your desired dates, we will send you a courtesy hold confirmation via email that is valid for 3 days.

Reservations require full payment of retreat package within 3 days of the time the reservation is made or tentative booking is automatically released.

Our Payment Policy
To secure your reservation, full payment is required within 3 days of receiving your tentative booking confirmation from us. Payment details will be provided once we have received your registration form and retreat availability has been confirmed. You may pay by Visa, MasterCard and bank transfer.