Register here for the Vital Health 5 Day Retreat at Eden Roc, Spain April 2019

Full Name

Address

Postcode

Home Telephone

Mobile Number

Email Address

Arrival Date (no later than Monday 1 April 2019)

Arrival Flight Number

Departure (no earlier than Sunday 7 April 2019)

Departure Flight Number

Arrival/Departure Airport Arrival/Departure Airport Barcelona Girona

Your transfer to/from hotel Your transfer to/from hotel I would like to be part of the group transfer on arrival I would like to be part of the group transfer on departure I will make my own arrangements

I would like to book the following room I would like to book the following room Standard Double/Twin Room – Single Occupancy €64.80 Standard Double/Twin Room – Twin Occupancy €46.80 per person Sea View Double/Twin Room – Single Occupancy €74.60 Sea View Double/Twin Room – Twin Occupancy €56.60 per person Superior Double Room (Port Salvi) – Single Occupancy €78.80 Superior Double Room (Port Salvi) – Twin Occupancy €60.80 per person Suite (Port Salvi) – Single Occupancy €96.30 Suite (Port Salvi) – Twin Occupancy €78.30 per person

For individuals who would like to share a double room. I would like to share my room with:

Juice fast therapy Juice fast therapy Yes, I would like to juice fast No, I would not like to juice fast

If you are juicing, please let us know if you have special dietary requirements :

Would you be happy to be part of a WhatsApp group for communication before and after the event? Would you be happy to be part of a WhatsApp group for communication before and after the event? Yes No

Have you read and agree to our T&Cs? Have you read and agree to our T&Cs? Yes, I agree No, I do not agree