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.