Pancha Prayag Yatra: Register and Deposit Form

[A] October 9 - 29, 2016 for $3045
[B] October 9 - 22, 2016 for $2100
Both options all inclusive: Airport group and individual pick-up and group drop-off, accommodation (Two in a room - Single rooms available upon request at extra charge - email info@namarupa.org), two Indian vegetarian meals and a snack a day, and transport in A/C Tempo Travelers. Early morning Ashtanga Yoga classes. Evening meditation and talks. Not included is your international air fare, drinking water, laundry, tips and sundries plus some temple fees. Helicopter or pony to Kedarnath also not included.

Download a BROCHURE with all the details and a full itinerary.
Download a TRAVEL WAIVER to sign and return.

Fill all fields in the form below and then click 'Submit and Pay'.

First name

Last name

Gender
MaleFemale

Age (Required for flight/train tickets)

Please choose one option
A: October 9-29B: October 9-22

Traveling alone?
YesNo

Traveling with

Email

Confirm Email

Phone

Street Address

City

State

Postal Code

Country

Emergency contact name

Emergency contact number

Please note any health issues or medications

Have you been to India before?
YesNo

If so, when and where?

Do you have previous experience with Indian philosophy (none required)?
YesNo

Do you practice yoga and/or meditation or similar (none required)?
YesNo

How did you hear about the Namarupa Yatra?

Your comments please

I have downloaded and read through the Pancha Prayag 2016 Flier.
Yes

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Click the Submit and Pay button above to submit the Registration Form. You will be automatically redirected to Paypal to make a $108 non-refundable deposit.

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