Payment/Participant Info | SINGING RETREATS

PARTICIPANT INFO

First name

Last name

Nationality

Birthday : kindly provide us with your exact birthday so we can assess the average age of the group and choose the appropriate singing material. Thank you!

E-mail

Confirm your E-mail

What city in Cambodia will you be coming from?

How did you hear about the retreat?

Emergency contact person: please provide the name of someone who can be reached in case of an emergency. This should not be the person accompanying you to the retreat.

E-mail: please provide an email address for your emergency contact (this must be different than your own, and cannot be the person accompanying you to the retreat).

Company name

Food allergies & intolerances

Your phone number

An additional $15 will be added to your bill to cover your transportation costs - I agree to the terms & conditions of this Singing Retreat (terms & conditions)

Please fill out the form below with your personal information. Once you've clicked 'submit', we'll receive your details and send you a payment link. If anything goes wrong while sending this form, please contact us and we'd be delighted to lend a hand.