Inscriptionform Purificationretreat

Name *

Voornaam

Achternaam

Email *

Telephone, preferably mobile number *

Birth date (year of birth is sufficient as well) *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Contactperson + telephonenumber in case of emergency during your stay in the Dojo

Purification retreat 6 - 10 april 2023

Total Amount

0,00 €

It is good for you to know the following about my actual physical and mental condition *

More *

I'd like to be informed of Okido Yoga Dojo activities through the newsletter (in Dutch)
I have read the terms and conditions on the website

A last remark (optional)