Booking Form

Fountainhead Organic Retreat

Your Name:
Address:


Internet Booking Bonus:
Please enter your address details above so that we can send Spa vouchers 

NB:
Short stays attract $100 in Spa money, 2 weeks or more $200. 3 weeks or more also will be given a 5% rebate cheque upon completion of your program.

Email:
Phone or mobile:
Please select: 2 Day Intensive
2-7 Days
16 Days
23 Days
28 Day Change your Life
1-3 Months

Fitness

Boot Camp (Fitness in a group)
13 Day Intensive with Endurance
21 Day with Breaking Habits
28 Day Change your Life 
 Other

Fit For Life (with your own personal trainer)

13 Day Intensive with Endurance
21 Day with Breaking Habits
28 Day Change your Life
 Other


Pamper & Baths Retreat

 6 Days 
15 Days
22 Days
28 Day Change your Life

Other
Optional Extras
That
Interest 
You:
Far Infrared Sauna
Body Work
Personal Training
Life Coaching
Journey Style Therapy
Date you wish to arrive:  Calendar
Click on the calendar icon to pick an arrival date
Purpose of visit:
 
Once we receive your booking, we will contact you by phone or email for more booking information and payment details