Yoga Getaway Registration

Please complete one registration form for each person. All fields marked * must be completed before the form can be submitted.

Yoga Getaway Dates
Name*
FirstLast
Gender
- Female
- Male
Email*
An automatic confirmation will be sent to this address when you submit this registration form. If this is a surprise gift for someone, please enter the recipient's email address in the \"Additional comments\" field at the end and enter your own email address here.
Phone (Day)
Please enter using this format: (888)888-8888
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Emergency Contact Information
Contact Name
FirstLast
Relationship with Contact
Contact Phone
Contact Email
How did you hear about this program?*
Please enter any other details or comments that will let us know how we reached you:
We offer a lacto-vegetarian yogic diet. While we do our best to provide options, we cannot guarantee that all restrictions can be accommodated.
Please list any dietary restrictions:
Please indicate your levels of yoga:
Yoga Postures*
Breathing/Pranayama*
Meditation*
Please list any health conditions or issues:
(e.g. high blood pressure, active asthma, pregnancy stage, active injuries and prescribed medications that you will be taking at the time of the program.)
Fees
Fees include tuition and accommodation (all facility usage, vegetarian meals, tea bar, and evening programs). HST will be added to all fees. While every effort will be made to provide your first choice for accommodation, on-site options fill up fast, so if you are willing to consider other accommodation choices, please select \"2nd Choice\" and \"3rd Choice\" options.
First Choice*
Fees listed= accommodation + tuition. HST will be added to these fees.
Second Choice
3rd Choice
If none of your choices is available, would you like to be placed on a waiting list?*
- Yes
- No, thanks
For those who would like to extend their stay at the Centre before and/or after the Yoga Getaway we offer the Personal Retreat option. Let us know how many extra nights you would like to stay and we will contact you about dates and availability.
- I would like to extend my stay at the Centre
Early Arrival Date (Personal Retreat Option)
Late Departure Date (Personal Retreat Option)
For those staying at the Centre, we offer $25 off for both you and your friend. If you're commuting, the discount is $10 each.
Your Friend's Name:
FirstLast
Wellness Centre
Interested in receiving a treatment at our on-site Ayurveda Wellness Centre? We recommend booking now to ensure that your preferred times are available. If your treatment coincides with a meal time, your meal can be set aside for you.
Treatment Requested:
Treatment Date*
Preferred Time*
PAYMENT METHOD*
- PayPal
- Credit Card (By Phone)
- Personal Cheque/Money Order
All fees must be paid in full to hold your reservation. Rates are quoted in Canadian dollars and include all applicable taxes. If you select PayPal as your payment method, a PayPal invoice will be emailed to you. If you wish to phone in your credit card information, please call us at 250.537.2326. Your credit card number will not be kept in our files subsequent to processing your payment. Please do not under any circumstances send your credit card information by e-mail. We also take Canadian or US cheques and/or money orders. Payments in US funds will be credited toward program fees at the prevailing exchange rate.
Please read the Salt Spring Centre's Cancellation Policy
Cancellation Policy*
- I have read the Salt Spring Centre's Cancellation Policy and agree to its terms.
If there are additional comments you would like to add to your registration, please enter them here:

Yoga Getaway Registration

Emergency Contact Information

Please indicate your levels of yoga:

Fees

Wellness Centre

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