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Please fill out the following form to make a reservation. We will respond within 24 hours to let you know whether a space is available and with payment instructions.

PLEASE FILL OUT THIS FORM ONLY IF YOU INTEND ON JOINING. FOR INQUIRIES ABOUT AVAILABILITY OF SPACE, SEND US AN E-MAIL INSTEAD.

Please add luangprabangyoga@gmail.com to your contacts to ensure that our responses do not end up in your spam folder. If you do not hear back from us within 24 hours, please check your spam folder or send us a direct e-mail.

* Indicates required field

Name *

First

Last

Age *

Male/Female *

Male Female

Email *

Country *

Retreat Date *

Number of people sharing a room *

Names of all people sharing the room *

Type of Bungalow *

Type of Room (Note there are only 2 twin rooms available) *

Dietary Restrictions *

Have you practice yoga before? *

How long (months/years) have you been practicing yoga? *

How many times per week/per month to you practice yoga? *

What type of yoga do you practice? *

Do you have any health concerns or injuries that we should know about? If so, please list and explain here. *

What do you hope to get out of this retreat? *

Other comments *

Name of travel agent or if other please specify: *

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