Full Name

Email Address

Contact Number

Date of Birth

Country of Residence

Do you have any pre-existing health conditions? If NOT, kindly answer N/A. If YES, Please share details and medication required. NOTE: Travel Insurance is NOT included as part of the cost. We recommend all participants to purchase individually.

Do you have any dietary requirements? Eg: food allergies. Note: We may be unable to cater for preferences

Emergency Contact (Name, Number and Relationship)

Where did you connect with Radhika Das?
OmNom KirtanAnother event in LondonAt a festivalPrevious retreat participantOnline only (Instagram / Facebook etc)Via a friendOther

Would you be interested in Private accommodation or a Shared Twin Room? *excl. flights. (Conversion according to your country of residence will be applicable).
Twin Standard Room (£1099)Single Room (£1600)

Anything we should know? (perhaps you wish to stay in a room with your partner)

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