Registration form - Anahata Center

First name

Last name

Date of birth

Address

Postal code

Recidence

Phone number

I hereby sign up for the following retreat/training:

Fire & Ice Experience for men

19 November 2023

Quart - Girona

€145

The reason I want to participate is:

I have the following dietary requirements (we eat vegetarian):

I have come into contact with Anahata center via:

Name and phone number of the person we can call in case of emergency:

If you're not going to attent to a retreat you can skipp the next question about the your stay at our retreat center.

We stay in the middle of nature at Can Bora Lodges
Ctra. Les Serres S/N, 17164 Constantins (Bonmati) - Spain – Girona area.

There are several options for accommodation. Your stay in a shared 2-person bedroom in a 4-person Nature Lodge is included in the price. Do you prefer to sleep alone in a room? This is possible at an additional cost of €150,-. Please keep in mind that you will be sharing the lodge with 1 or 2 other persons.
The Nature Lodge does not have its own sanitary facilities. You can use the showers and toilets in a separate building (about 50 meters away from the lodges). Do you prefer a shower and toilet in the lodge? For an additional cost of €100 you can stay in the Comfort Lodge.

Make your choice here:
Stay in a shared 2-person bedroom in a 4-person Nature Lodge (no extra charge)Private use of a 2-person bedroom in a 4-person Nature Lodge (additional price €150)The Comfort Lodge in a 2-person bedroom (additional cost €100)Upgrade to a stay in the 4-person Comfort Lodge ánd private use of a 2-person bedroom (surcharge €250)
Ultimatly, please fill out the next questions:
I declare that I have no mental or psychic illnessI agree that my email address and telephone number will be shared with the other participants of the retreat I am registering forI agree that my data will be stored for billing and information purposesI agree to the terms and conditions and I am aware of the cancellation policy