Detox and wellness online holidays and retreats reservations
“Things that are truly of merit require time and patience in order to be fulfilled”
∼ Swami Kripalu

Detox and Wellness Reservation Form

1. Personal Information:
  First Name
  Last Name
  Email address
  Country of Residence
  Gender  Male
 Female
2. Select the dates you would like to come for:
  Arrival Date
  Departure Date
3. Select your choice of accommodation:
   Single
 Shared
 Non-residential (if you do not need accommodations)
4. Detox Program - indicate your desired length of time:
 
Standard Detox Program
 

 3 days
 5 days
 7 days
 10 days
Essential Detox Program
(includes Colon Hydrotherapy)

 3 days
 5 days
 7 days
 10 days
  Add on any extra nights:

on Detox Program (€ 122 share/ € 152 single) (extra night rates includes accommodation, detox meals and herbal supplements, any extra treatments special discount at 30%)
or on Yoga Residential stay (€ 98 share/ € 128 single)		  

# nights
# nights
5. Wellness Program - indicate your desired program and length of time:
 
  Add on any extra nights:

on Wellness Program (€ 98 share/ € 128 single, only includes accommodation and meals, any extra treatments special discount at 30%)
or on Yoga Residential stay (€ 98 share/ € 128 single)		  

# nights
# nights
6. Your Choice of Three/ Five/ Seven Days of Personal and Spiritual Transformation
   2 days / 3 nights
 4 days / 5 nights
 6 days / 7 nights
  Add on any extra nights:

on Wellness Program (€ 98 share/ € 128 single, only includes accommodation and meals, any extra treatments special discount at 30%)
or on Yoga Residential stay (€ 98 share/ € 128 single)		  

# nights
# nights
7. If there is a need please add any additional information here:
Samahita Wellness does not claim to be a medical faculty and advises that the health of the individual is their own responsibility. It is important to seek medical advice regarding any health concerns before participating in a detox program. We are not in the position to treat people with serious mental or emotional illnesses who are on prescribed psychiatric medication. If you are currently taking any serious medication for health issues please provide us with a note from your doctor regarding the condition and his/her approval for you to partake in such a program. Thank you.