Registration Form

Do you speak english? YesNo
Do you currently or do you have a history of suffering from an eating or exercise disorder? YesNo
Do you have any Allergies to food, the environment or anything else? YesNo
Do you use drugs? YesNo
Do you smoke? YesNo
Do you drink alcohol? YesNo
Do you have any challenges in participating in physical activities? YesNo
Do you have any current or past injuries? YesNo
Do you require assistance during the course due to the above injury or medical condition? YesNo
Do you have any special dietary requirements ? YesNo


Bank Transfer
BCA (Bank Central Asia)
Address: Jl. Hasanudin 5 Denpasar, Bali
Name: Ni Putu Ike Rahayu Martini J
Account: 0402078667
Swift Code: CENAIDJA

Paypal Details



  •  Non-refundable deposit of USD500,- and the balance of payment is receive before the retreat start or maximum payment is on the registration day. Cash $USD.
  • Deposits are not refundable but transferable to any Kaivalya Spirit retreats or workshops within 12 months of receipt.
  • 50% refund of full payment for cancelation within 15 days before retreat start date
  • Full payment is non-refundable (but transferable within 12 months) if cancelation is not made within 15 days of the retreat start date.
  • All the room are queen size bed for one person only (Please let us know if you wish to have a twin/triple sharing room. We could help to organize it.)
  • Don’t hesitate to contact us at for any questions or greater detailed information.



  • Please complete the registration form and read the terms and conditions carefully to avoid any misunderstandings in the future.
  • Please be inform that using phone during the retreat is not allowed. After the retreat finished at the end of the day, participants can use their phone.
  • Please confirm what method of payment you plan to use.
  • We will send your invoice after the payment is received.
  • Participant is responsible for bank fee and Kaivalya Spirit expects total balance of workshop fee.
  • Once the course has commenced Kaivalya Spirit cannot refund any money, even if the course is not completed by the participant. If the situation has extrame circumstances, Kaivalya spirit will openly discuss the matter with compassion.
  • If you have any questions or suggestions please contact us at