Name(s) in full: ___

Name you are usually called by: ___

Address: ___

City: __    State or province: ___   Country: ___

Zip or pin code: ___

Phone:

Mobile___     Landline ___

E-mail address ___

I (we) plan to take the following meals at the retreats:

Mahasamadhi Retreat

___Friday, 2 March dinner
___Saturday, 3 March lunch
___Sunday, 4 March lunch
___Sunday, 4 March dinner

Kriya Yoga Retreat

___Thursday, 8 March dinner
___Friday, 9 March lunch
___Saturday, 10 March lunch
___Sunday, 11 March lunch