May 2018 Bali Yoga Retreat : Registration Form

Join Diane Cline, RYT, On An Epic Spiritual Journey to the “Island of the Gods” Bali, Indonesia May 2018

Register Now: May 2018 Bali Yoga Retreat

* Please be sure to first read our Retreat Registration Policy for information on rates, discounts, deadlines & policies as well as, payment options.

Bali, Indonesia Yoga, Meditation & Sound Wellness Retreat: MAY 19 – 26th, 2018

Thank you for joining our exclusive retreat in Bali, Indonesia this May 2018.  Our aim is to offer you an experience of your highest truth and light as you expand…Into the Bliss!

Please completely fill-out the form below, then click “Submit” to secure your reservation.

Your Name (required)

Phone Number (include U.S. & International Area Codes)

Your Email (required)

Street Address

Street Address #2 (if applicable)




Room Preference
All room options are first come, first serve following full payment reservations.

Method of Payment

I have read the May 2018 Bali Retreat Registration Policy

Digital Print Signature

Please type your full legal name here to confirm your contact information, plus registration details with deposit or full payment to confirm your spot.

Emergency Contact (full name)

Emergency Contact Phone (include U.S. & International area codes)

Are You Planning to Rent a Car?

Injuries or Medical Conditions (please list here)

Please also include any conditions or helpful details we should aware of during the retreat.

Food Allergies &/or Special Requests?

All meals will be primarily vegetarian (although there will be eggs at breakfast & fresh local fish on two or three evenings.

Other Allergies or Information?

Please include any other allergies and details for retreat organizers here.

Contemplation Point: What are your highest intentions for the retreat?

There will be plenty of time for journaling and reflecting on your experience(s). What you learn at this retreat you can use the rest of your life!

Additional Notes

Important Note:
If paying by Paypal: make note of the total amount based on your room preference from above, as you will have to manually enter this amount into Paypal after you click the "Pay Now" button below.

If paying by Check: make note of the total amount based on your room preference from above, then click the "Pay Now" button below to submit your form. (Disregard the Paypal screen that follows.)

Questions before booking?

Call Diane at 1-(480) 244-7676 or send an email via the Contact page.