Book Ayurveda Retreat

Hello and thank you for connecting with Jai here. I am very glad this has sparked your interest and you are ready to claim your spot at our upcoming goddess retreat. I have been feeling the desire to run this retreat for many years.

Any questions, clarifications, musings, please feel very welcome to reach out.

Please fill out the form below.

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Last Name

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Date of Birth

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Suburb, State & Post Code

What is your occupation?

Identity

Emergency Contact & Mobile

Do you have any physical, mental or emotional conditions or limitations that we should know about, or may prevent your full participation in this retreat? Please note: all participation is optional. This is just so we know where you are at.

Facebook and /or Instagram

Choose Your Accommodation Option

Payment Option

Do you have any dietary requirements?

All meals will be vegetarian and based on Ayurvedic principles.

Vegan

Dairy Free

Gluten Free

Celiac

Other allergy - please include in the notes below.

Please leave any questions, comments or notes below-

I understand that by booking my spot today a $500 non refundable deposit is required (direct deposit details will appear once you submit this booking form)

Yes I understand and am happy to put through my deposit now!

Have a query or wish to discuss further?

Please leave your details below and Jane will be in contact to arrange a time to connect.

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