Name *

First Name

Last Name

Phone *

Country

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###

####

Date of birth *

MM

DD

YYYY

Course dates

Please enter the start date of your course

MM

DD

YYYY

Are you able to regularly and comfortably participate in group program twice a day, including Yogi Flying?

Yes

No

Maybe

Do you lift off during Yogic flying?

Yes

No

Other

If you will have recently completed Panchakarma (within the last 4 weeks) please provide a certificate from your Vaidya to confirm that you are healthy and fit to visit the Himalayas (high altitude) and have had no post treatment difficulties or symptoms occur.

Yes, I will email this certificate to thaimdcourses@gmail.com before I travel

Please note that our facility is located at 5600 ft elevation and requires a good level of physical fitness. Guests must be able to walk up and down multiple flights of stairs several times daily. This retreat location is not suitable for individuals with mobility challenges or certain health conditions. It is always advisable to consult your doctor before undertaking long-distance travel.

I understand the conditions of the location and confirm that I am in good health.

Other

Please let us know what type of and length of courses you are interested in so we can improve our course offering

Please tick all relevant options

Weekend course

1 week

2 week

One month

6 months

I am interested in the Mother Divine lifestyle and longer rounding courses - 1 year - 3 years