Nautical Namaste Booking Form

"*" indicates required fields

CONTACT DETAILS

Name*
Email*
Address*

A BIT ABOUT YOU

There will be no WiFi on board Annabella. Are you ready to disconnect? Is the world around you ready for your disconnection?*

EMERGENCY CONTACT DETAILS

Emergency Contact Name*

PAYMENT

Are you the final decision maker in regards to paying for your retreat??*
If No, do you have the bill payers permission to paying for this retreat?*
An invoice to pay the balance will be sent to you each month on the date you pay your non-refundable deposit. Please choose your balance instalment plan:*

PERSONAL DECLARATION

I declare the above information is correct and will inform you of any future changes.
Name*