Personal Revolution Yoga Retreat

Registration Methods :

(1) ONLINE - please complete registration form below OR

(2) By FAX - please complete registration form on flyers available at any Pure Yoga studio and fax to (852) 3520-4999

(3) By PHONE - please contact Pure Yoga Events at (852) 3691-3843

Fields marked * are required.

First Name:*

Last Name:*

Pure Membership No. : (if applicable):

Gender:*

	Male
	Female

City:

Country:

Mobile:*

Other Contact No.:

Email:*

Confirm Email:*

Emergency Contact Person & Number:

ACCOMMODATION

* Partners must also submit a separate registration.

Please Check Room Type Below	Regular Price	Pure Early-Bird (ends 26 Aug)
Single Room	FULL	FULL
Twin Room	HK$12,888	HK$11,599
Partner Name:

TO CONFIRM YOUR REGISTRATION

1. Upon your received registration, you will be sent a confirmation letter with a Waiver and Payment Form

2. Both waiver and payment must be received fully completed to confirm your space

3. If faxing registration / payments, please call Pure Yoga Events at (852) 3691-3843 to confirm receipt

1. Any injuries? If so, please specify:

2. How long have you been practising yoga?:

3. How did you hear about this retreat?

Poster / Flyer
Email
Internet / Pure Yoga website
Magazine / Media Ad
Pure Yoga Staff
Friend / Family
Other

By submitting your application, you agree to the following Terms and Conditions*

	Yes
	No

Please type the code shown in the above image: (four digit number - no spaces)

Pure Cardholder Early-Bird 10% Discount:
- Last day for Pure Early-Bird Discount is 26 August

Refunds/Cancellation:
- No refund or credit will be given in the case of cancellation starting 26 August

Enquiries:
- For enquiries, please contact Pure Yoga Events at (852) 3691-3843 / (852) 3691-3842

Hong Kong travel agent: Plan Travel Ltd. Licence No: 350038