Online payment

"; //$to .= "[email protected]>"; $subject = "Yoga Retreat Registration"; $message = "Personal Information: Emergency ContactsCancellation Policy
Name:$name
Address:$address
City:$city
State:$state
Country:$country
Email:$email
Phone:$phone
Occupation:$occupation
Retreatdate:$retreat_date
Birthdate:$birth_date
Retreat:$retreat
Gender:$gender
Comments:$comments
Name:$emergency_name1
Relationship:$emergency_relationship
Email:$emergency_email
Phone:$emergency_phone
Referral:$referral
Internet:$internet
Advertising:$advertising
Other:$other
CancellationPolicy:I UNDERSTAND THE ABOVE POLICY.
ActivitiesWaiver::I AGREE TO THE ABOVE TERMS
ParticipationAgreement:I AGREE TO THE ABOVE TERMS.
Signature:$signature
Date:$signature_date
"; $headers = "Content-type: text/html; charset=utf-8 \r\n"; $headers .= "From: blissbodyretreat.com \r\n"; //$headers .= "Reply-To: [email protected]\r\n"; mail($to, $subject, $message, $headers); } ?>

Your profile has been sent

Dear ,

We highly appreciate your effort in taking time to submit this registration form.

Thank you! We are excited to welcome you to our retreat soon.

Bliss Body Retreat

"; //$to .= "[email protected]>"; $subject = "Yoga Retreat Registration"; $message = "Personal Information: Emergency ContactsCancellation Policy
Name:$name
Address:$address
City:$city
State:$state
Country:$country
Email:$email
Phone:$phone
Occupation:$occupation
Retreatdate:$retreat_date
Birthdate:$birth_date
Retreat:$retreat
Gender:$gender
Comments:$comments
Name:$emergency_name1
Relationship:$emergency_relationship
Email:$emergency_email
Phone:$emergency_phone
Referral:$referral
Internet:$internet
Advertising:$advertising
Other:$other
CancellationPolicy:I UNDERSTAND THE ABOVE POLICY.
ActivitiesWaiver::I AGREE TO THE ABOVE TERMS
ParticipationAgreement:I AGREE TO THE ABOVE TERMS.
Signature:$signature
Date:$signature_date
"; $headers = "Content-type: text/html; charset=utf-8 \r\n"; $headers .= "From: blissbodyretreat.com \r\n"; //$headers .= "Reply-To: [email protected]\r\n"; mail($to, $subject, $message, $headers); } ?>

Payment

Choose your retreat*
  • Pay with PayPal
  • Pay with Card
Pay with PayPal

Note* Currency is USD

*After Submitting you will be transferred to the page where you will need to enter the details of your card.