Namarupa Yatra 2015 + Ashtanga Yoga Sadhana Retreat Register & Deposit Form

Please note that there are only a few places left. To register please fill in and submit the form along with a deposit. We will contact you right away with details. Thank you.

First name

Last name

Gender
MaleFemale

Age (Required for train tickets)

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

Please choose one option
---Ashtanga Yoga Sadhana Retreat only: 6 Days Ashram+Meals $850Ashtanga Yoga Sadhana Retreat only: 6 Days Hotel+Meals $950Ashtanga Yoga Sadhana Retreat Yatra: 12 Days Ashram $1800Ashtanga Yoga Sadhana Retreat Yatra: 12 Days Hotel $1900Plains Yatra + Ashtanga Yoga Sadhana Retreat: 19 Days $3150Mountains Yatra + Ashtanga Yoga Sadhana Retreat: 23 days $3550Plains Yatra only: 16 days $2700Mountains Yatra only: 17 Days $2650Full Yatra + Ashtanga Yoga Sadhana Retreat: 30 days $3900

I have downloaded and read through the Yatra 2015 PDF.
Yes