BRANDHUMAN-AMAVEDA JUNE 2019 Registration Page BODY | MIND | BUSINESS | JUNE 21-30 2019 Full Name*Email* TelephoneAgeCityHow is your overall health? Under doctors supervision With some health issues Average Above average HEALTH ISSUES - Please list any illnesses or health issues. Make sure to list all present medications and or treatments. YOGA - What level is your yoga practice? Complete beginner Occasional yoga class As often as possible Dedicated practice I am a yoga teacher GOALS - What would you like to accomplish by attending this retreat?KICHIC ROOM CHOICE* BARRO US$ 5800.00 PIEDRA US$ 5800.00 HUALTICO US$ 5800.00 ELEFANTE US$ 6800.00 KI US$ 6800.00 SUITE HIMALAYA US$ 7800.00 SUITE NEEM US$ 7800.00 SUITE BALANCE US$ 7800.00 SUITE CHIC US$ 7800.00 INDICATE YOUR PREFERRED PAYMENT METHOD* STRIPE online credit card payments PayPay (+ 4.5%) $US Bank deposit to Peruvian dollars account £UK Bank deposit to UK Sterling account (with today's exchange rate) We will respond with a payment request via your preferred method or the appropriate payment details. How did you hear about the BrandHuman-Amaveda retreat?