Booking Form

Booking Form

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*

Daytime phone number (inc country code)*
Daytime phone number (inc country code)*

Date Of Birth (ddmmyy)*
Date Of Birth (ddmmyy)*

Female/Male*
Female/Male*

	Female
	Male

Vegetarian

	Yes
	No

Vegan

	Yes
	No

Other dietary requirements

Occupation

How much yoga have you done before?*
How much yoga have you done before?*

	None
	Less than six months
	More than six months
	More than three years
	More than six years

If you have done yoga before, which type was it?

Do you have any injuries or illness?*
Do you have any injuries or illness?*

	Yes
	No

If so, please give details

What type of room would you prefer?*
What type of room would you prefer?*

	Double room
	Share of a Twin room (subject to availability)
	Single room (�70 supplement)
	Family room

Do you want to share a room with a partner or friend?*
Do you want to share a room with a partner or friend?*

	No
	Yes - I'd like to share a double room
	Yes - I'd like to share a twin room

If so, please tell us their name (they will have to fill in their own booking form)

What are the dates you would like to come? (ddmmyy - ddmmyy)*
What are the dates you would like to come? (ddmmyy - ddmmyy)*

Have you booked a flight yet?*
Have you booked a flight yet?*

If you have, what is the date, time and flight number of your flight to Antalya?

What is the date, time and flight number of your flight home?

You are required to have your own travel insurance.*
You are required to have your own travel insurance.*

	Yes, I have my own travel insurance
	No, I do not yet have insurance

Have you been on a Heliotrope Yoga Holiday before?

	Yes
	No

If not, how did you hear about us?

	Through a friend
	Through a teacher
	Website
	Brochure
	Other

Please confirm that you agree with our terms and conditions.*
Please confirm that you agree with our terms and conditions.*

Yes, I have read and agree with the terms and conditions

I am sending a cheque payable to Heliotrope Yoga Holidays, to Heliotrope Yoga Holidays, 140 Murchison Road, London, E10 6LX*
I am sending a cheque payable to Heliotrope Yoga Holidays, to Heliotrope Yoga Holidays, 140 Murchison Road, London, E10 6LX*

	I am sending full payment of �375
	I am sending full payment + single supplement i.e. �445
	I am sending a deposit of �75
	I am sending some other amount

The above amounts include �5 to offset the carbon emissions of your flights*
The above amounts include �5 to offset the carbon emissions of your flights*

	Yes, I want to offset my carbon emissions
	I don't want to offset my emissions and am deducting �5 from the cost of my holiday.

Upon receipt of your payment we will send you a booking confirmation/receipt*
Upon receipt of your payment we will send you a booking confirmation/receipt*

	I'd like it posted to me
	I'd like it emailed to me as a word document

Please enter the word that you see below.