Participant Form:
India Smiling Soul Retreat
I'd like to book for the India Smiling Soul Retreat on:
30 October - 8 November 2023
2024
+27
Country code…
+1
United States
+1
Canada
+44
United Kingdom
+61
Australia
+93
Afghanistan
+357
Akrotiri
+358
Aland Islands
+355
Albania
+213
Algeria
+376
Andorra
+244
Angola
+54
Argentina
+374
Armenia
+297
Aruba
+247
Ascension Island
+61
Australia
+43
Austria
+994
Azerbaijan
+973
Bahrain
+880
Bangladesh
+375
Belarus
+32
Belgium
+501
Belize
+229
Benin
+975
Bhutan
+591
Bolivia
+387
Bosnia and Herzegovina
+267
Botswana
+55
Brazil
+246
British Indian Ocean Territory
+673
Brunei Darussalam
+359
Bulgaria
+226
Burkina Faso
+257
Burundi
+855
Cambodia
+237
Cameroon
+1
Canada
+34
Canary Islands
+238
Cape Verde
+236
Central African Republic
+34
Ceuta and Melilla
+235
Chad
+56
Chile
+86
China
+61
Christmas Island
+61
Cocos (Keeling) Island
+57
Colombia
+269
Comoros
+242
Congo
+243
Congo - Democratic Republic of the Congo
+682
Cook Islands
+506
Costa Rica
+225
Côte D'Ivoire
+385
Croatia
+53
Cuba
+357
Cyprus
+90
Cyprus - Turkish Republic of Northern Cyprus
+420
Czech Republic
+45
Denmark
+357
Dhekelia
+253
Djibouti
+593
Ecuador
+20
Egypt
+503
El Salvador
+240
Equatorial Guinea
+291
Eritrea
+372
Estonia
+251
Ethiopia
+500
Falkland Islands
+298
Faroe Islands
+679
Fiji
+358
Finland
+33
France
+594
French Guiana
+689
French Polynesia
+262
French Southern and Antarctic Lands
+241
Gabon
+220
Gambia
+995
Georgia
+49
Germany
+233
Ghana
+350
Gibraltar
+30
Greece
+299
Greenland
+590
Guadeloupe
+502
Guatemala
+224
Guinea
+245
Guinea-Bissau
+592
Guyana
+509
Haiti
+39
Holy See (Vatican City State)
+504
Honduras
+852
Hong Kong
+36
Hungary
+354
Iceland
+91
India
+62
Indonesia
+98
Iran, Islamic Republic Of Iran
+964
Iraq
+353
Ireland
+972
Israel
+39
Italy
+1
Jamaica
+81
Japan
+962
Jordan
+7
Kazakhstan
+254
Kenya
+686
Kiribati
+850
Korea, Democratic People's Republic Of Korea
+82
Korea, Republic of Korea
+383
Kosovo
+965
Kuwait
+996
Kyrgyz Republic
+856
Laos
+371
Latvia
+961
Lebanon
+266
Lesotho
+231
Liberia
+218
Libya
+423
Liechtenstein
+370
Lithuania
+352
Luxembourg
+853
Macao
+389
Macedonia
+261
Madagascar
+265
Malawi
+60
Malaysia
+960
Maldives
+223
Mali
+356
Malta
+692
Marshall Islands
+596
Martinique
+222
Mauritania
+230
Mauritius
+269
Mayotte
+52
Mexico
+691
Micronesia
+373
Moldova
+377
Monaco
+976
Mongolia
+382
Montenegro
+212
Morocco
+258
Mozambique
+95
Myanmar
+264
Namibia
+674
Nauru
+977
Nepal
+31
Netherlands
+599
Netherlands Antilles
+687
New Caledonia
+64
New Zealand
+505
Nicaragua
+227
Niger
+234
Nigeria
+683
Niue
+672
Norfolk Island
+47
Norway
+968
Oman
+92
Pakistan
+680
Palau
+970
Palestine
+507
Panama
+675
Papua New Guinea
+86
Paracel Islands
+595
Paraguay
+51
Peru
+63
Philippines
+48
Poland
+351
Portugal
+974
Qatar
+262
Réunion
+40
Romania
+7
Russian Federation
+250
Rwanda
+290
Saint Helena
+508
Saint Pierre and Miquelon
+685
Samoa
+378
San Marino
+239
São Tome and Principe
+966
Saudi Arabia
+221
Senegal
+381
Serbia
+248
Seychelles
+232
Sierra Leone
+65
Singapore
+421
Slovakia
+386
Slovenia
+677
Solomon Islands
+252
Somalia
+252
Somaliland
+27
South Africa
+211
South Sudan
+34
Spain
+94
Sri Lanka
+249
Sudan
+597
Suriname
+47
Svalbard and Jan Mayen
+268
Swaziland
+46
Sweden
+41
Switzerland
+963
Syria
+886
Taiwan
+992
Tajikistan
+255
Tanzania
+66
Thailand
+670
Timor-Leste
+228
Togo
+690
Tokelau
+676
Tonga
+290
Tristan da Cunha
+216
Tunisia
+90
Turkey
+993
Turkmenistan
+688
Tuvalu
+256
Uganda
+380
Ukraine
+971
United Arab Emirates
+44
United Kingdom
+1
United States
+699
United States Minor Outlying Islands
+598
Uruguay
+998
Uzbekistan
+678
Vanuatu
+58
Venezuela
+84
Viet Nam
+681
Wallis and Futuna Islands
+212
Western Sahara
+967
Yemen
+260
Zambia
+263
Zimbabwe
Country code…
+1 (United States)
+1 (Canada)
+44 (United Kingdom)
+61 (Australia)
+93 (Afghanistan)
+357 (Akrotiri)
+358 (Aland Islands)
+355 (Albania)
+213 (Algeria)
+376 (Andorra)
+244 (Angola)
+54 (Argentina)
+374 (Armenia)
+297 (Aruba)
+247 (Ascension Island)
+61 (Australia)
+43 (Austria)
+994 (Azerbaijan)
+973 (Bahrain)
+880 (Bangladesh)
+375 (Belarus)
+32 (Belgium)
+501 (Belize)
+229 (Benin)
+975 (Bhutan)
+591 (Bolivia)
+387 (Bosnia and Herzegovina)
+267 (Botswana)
+55 (Brazil)
+246 (British Indian Ocean Territory)
+673 (Brunei Darussalam)
+359 (Bulgaria)
+226 (Burkina Faso)
+257 (Burundi)
+855 (Cambodia)
+237 (Cameroon)
+1 (Canada)
+34 (Canary Islands)
+238 (Cape Verde)
+236 (Central African Republic)
+34 (Ceuta and Melilla)
+235 (Chad)
+56 (Chile)
+86 (China)
+61 (Christmas Island)
+61 (Cocos (Keeling) Island)
+57 (Colombia)
+269 (Comoros)
+242 (Congo)
+243 (Congo - Democratic Republic of the Congo)
+682 (Cook Islands)
+506 (Costa Rica)
+225 (Côte D'Ivoire)
+385 (Croatia)
+53 (Cuba)
+357 (Cyprus)
+90 (Cyprus - Turkish Republic of Northern Cyprus)
+420 (Czech Republic)
+45 (Denmark)
+357 (Dhekelia)
+253 (Djibouti)
+593 (Ecuador)
+20 (Egypt)
+503 (El Salvador)
+240 (Equatorial Guinea)
+291 (Eritrea)
+372 (Estonia)
+251 (Ethiopia)
+500 (Falkland Islands)
+298 (Faroe Islands)
+679 (Fiji)
+358 (Finland)
+33 (France)
+594 (French Guiana)
+689 (French Polynesia)
+262 (French Southern and Antarctic Lands)
+241 (Gabon)
+220 (Gambia)
+995 (Georgia)
+49 (Germany)
+233 (Ghana)
+350 (Gibraltar)
+30 (Greece)
+299 (Greenland)
+590 (Guadeloupe)
+502 (Guatemala)
+224 (Guinea)
+245 (Guinea-Bissau)
+592 (Guyana)
+509 (Haiti)
+39 (Holy See (Vatican City State))
+504 (Honduras)
+852 (Hong Kong)
+36 (Hungary)
+354 (Iceland)
+91 (India)
+62 (Indonesia)
+98 (Iran, Islamic Republic Of Iran)
+964 (Iraq)
+353 (Ireland)
+972 (Israel)
+39 (Italy)
+1 (Jamaica)
+81 (Japan)
+962 (Jordan)
+7 (Kazakhstan)
+254 (Kenya)
+686 (Kiribati)
+850 (Korea, Democratic People's Republic Of Korea)
+82 (Korea, Republic of Korea)
+383 (Kosovo)
+965 (Kuwait)
+996 (Kyrgyz Republic)
+856 (Laos)
+371 (Latvia)
+961 (Lebanon)
+266 (Lesotho)
+231 (Liberia)
+218 (Libya)
+423 (Liechtenstein)
+370 (Lithuania)
+352 (Luxembourg)
+853 (Macao)
+389 (Macedonia)
+261 (Madagascar)
+265 (Malawi)
+60 (Malaysia)
+960 (Maldives)
+223 (Mali)
+356 (Malta)
+692 (Marshall Islands)
+596 (Martinique)
+222 (Mauritania)
+230 (Mauritius)
+269 (Mayotte)
+52 (Mexico)
+691 (Micronesia)
+373 (Moldova)
+377 (Monaco)
+976 (Mongolia)
+382 (Montenegro)
+212 (Morocco)
+258 (Mozambique)
+95 (Myanmar)
+264 (Namibia)
+674 (Nauru)
+977 (Nepal)
+31 (Netherlands)
+599 (Netherlands Antilles)
+687 (New Caledonia)
+64 (New Zealand)
+505 (Nicaragua)
+227 (Niger)
+234 (Nigeria)
+683 (Niue)
+672 (Norfolk Island)
+47 (Norway)
+968 (Oman)
+92 (Pakistan)
+680 (Palau)
+970 (Palestine)
+507 (Panama)
+675 (Papua New Guinea)
+86 (Paracel Islands)
+595 (Paraguay)
+51 (Peru)
+63 (Philippines)
+48 (Poland)
+351 (Portugal)
+974 (Qatar)
+262 (Réunion)
+40 (Romania)
+7 (Russian Federation)
+250 (Rwanda)
+290 (Saint Helena)
+508 (Saint Pierre and Miquelon)
+685 (Samoa)
+378 (San Marino)
+239 (São Tome and Principe)
+966 (Saudi Arabia)
+221 (Senegal)
+381 (Serbia)
+248 (Seychelles)
+232 (Sierra Leone)
+65 (Singapore)
+421 (Slovakia)
+386 (Slovenia)
+677 (Solomon Islands)
+252 (Somalia)
+252 (Somaliland)
+27 (South Africa)
+211 (South Sudan)
+34 (Spain)
+94 (Sri Lanka)
+249 (Sudan)
+597 (Suriname)
+47 (Svalbard and Jan Mayen)
+268 (Swaziland)
+46 (Sweden)
+41 (Switzerland)
+963 (Syria)
+886 (Taiwan)
+992 (Tajikistan)
+255 (Tanzania)
+66 (Thailand)
+670 (Timor-Leste)
+228 (Togo)
+690 (Tokelau)
+676 (Tonga)
+290 (Tristan da Cunha)
+216 (Tunisia)
+90 (Turkey)
+993 (Turkmenistan)
+688 (Tuvalu)
+256 (Uganda)
+380 (Ukraine)
+971 (United Arab Emirates)
+44 (United Kingdom)
+1 (United States)
+699 (United States Minor Outlying Islands)
+598 (Uruguay)
+998 (Uzbekistan)
+678 (Vanuatu)
+58 (Venezuela)
+84 (Viet Nam)
+681 (Wallis and Futuna Islands)
+212 (Western Sahara)
+967 (Yemen)
+260 (Zambia)
+263 (Zimbabwe)
Validity of Passport: Do you currently hold a valid passport that is valid for at least 6 months from date of arrival in India, with at least 2 blank passport pages for stamping?
Yes
No
Do you currently have or have you ever been diagnosed with any form of depression, psychiatric treatment, or mental illness?
Yes
No
If you are still being treated have you got consent from your doctor to attend the Retreat
Yes
Not Applicable
Do you require an airport pick-up? (Complimentary on Day 1 of Retreat).
Yes
No
Do you require airport drop-off (Complimentary on last day of Retreat)?
Yes
No
As flights and travel insurance, as well as visa costs do not form part of the Retreat package, do you require assistance from our preferred Travel Vendor to get a quote for (domestic and) international flights?
Yes
No
Are you a smoker or non-smoker? This information is confidential and assists us with room allocation if you are on a sharing package.
Smoker
Non-smoker
Accomodation
Sharing (by default)
Own room (supplement of additional $600)
If you are not travelling with anyone we will pair you with a participant that is most suited for you to share with, of the same gender together. Are you open to sharing a room with a participant of the opposite gender?
Yes
No
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