| City,
State, Zip:* |
|
Preferred Date (1st Choice):*
|
|
Preferred Date (2nd Choice):
|
|
Preferred Date (3rd Choice):
|
|
| |
|
No. of Guests:* (min 5 people)
|
|
| Special
Occasion:* |
|
| Spa
Day Retreat Location:*
(Choose where you would to have your Spa Day Retreat) |
House/Town House
Apartment/Condo
Church
Office |
| Add
Optional Upgrades:* |
Guided Meditation
Yoga Lovers
Henna Body Art
Light Snacks
Wine Bar
Decadent Desserts |
.
. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . |
| Payment
Information: (25% Deposit Required) * |
|
Credit Card Number:
Expiration Date:
/
|
| Credit
Card Type: Visa
MC
Amex
CVV Code:
|
| |
| |
.
. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . |
| How
did you hear about us: |
|