Registration Form | Reservations | Panacea de la Montaña

Yoga retreat reservations for Panacea de la Montaña, Tamarindo, Costa Rica

Reserve your spot at Panacea de la Montaña, Costa Rica! Simply print out this yoga retreat reservation page, complete and fax it to us toll-free at (866) 241-4535. (For airline and airport information, click here.)

Please be sure to include your credit card information and cardholder signature. Every effort will be made to confirm your reservation by e-mail within 24-48 hours after receiving your completed faxed reservation.

Your credit card will be charged a deposit of 50% of the total due amount at the time of booking. Your balance will be due at the time of your departure, payable with either cash or credit card (Visa or MasterCard).

Desired Rate Plan			Include Life Plan?		Include Special Event Options (indicate desired event below)?
	3-Night Package	4-Night Package		Yes		Yes
	7-Night Package	Nightly Stay only		No		No
	Day Spa only	Group Rate		Not Sure; tell me more		Not Sure; tell me more

Please list Special Requests/Special Event(s) desired: ________________________________________________________________

Dates of Reservation

Check-in Date *	_____________/_______/__________ month date year
Check-out Date *	_____________/_______/__________ month date year
*Reservations subject to availability.

# of Cabinas Requested	______________________
(Maximum of 3 people per cabina)
# of Guests	______________________
# of Guests under age 18	______________________
(For Family Week only)

About You
Title	Mr. Mrs. Ms. Dr.
First Name	______________________	Last Name	______________________
Address Line 1	______________________	Address Line 2	______________________
City	______________________	State / Province	______________________
Zip Code / Postal Code	______________________	Country	______________________
Day Telephone (include area code and country code)	______________________	Evening (include area code and country code)	______________________
Email Address	______________________

Credit Card Information
Credit Card	Visa Master Card	Credit Card Number	______________________
3-Digit CVV Code (appears on back of card, to the right of credit card number)	______________________	Credit Card Expiration Date	_________/__________ month year
Name as it appears on card	______________________	Card Holder Signature	______________________

By completing and signing this form, I agree to all Panacea payment terms and policies.
Payment Policy | Terms & Conditions | Cancellations | Privacy Policy

Please print, complete, sign and fax toll-free to (866) 241-4535. Thank you!

Panacea de la Montaña
Apartado 23 Villa Real
Santa Cruz, Guanacaste, Costa Rica
Phone 011 506 2653 8515 • Toll-Free Fax (866) 241-4535 • info@panaceacr.com