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Please pay for retreat here - full/deposit here
(This will open up a new page leaving this form on the screen to complete after payment is made) - then complete the form below.

Thanks
Lara Warren Retreat in Costa Rica
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Country*
Home Phone
Business Phone
Fax
Accomodation:*
Bungalow: Double occupancy @ £1095 ($2165)
Bungalow: Single Occupancy @ £1445 ($2855)
Hacienda: Double occupancy @ £1020 ($2020)
Hacienda: Single occupancy @ £1295 ($2565)
Platformed: Double occupancy @ £915.00 ($1810)
Platformed: Single occupancy @ £1155 ($2285)
I would like to :*
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