Azur Wellness

Juice & Soup Detox

Juice & Soup Weekend Booking Form

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Please choose which dates you would like to stay with us:

Personal Information

First name

Surname

Address

Postal Code

Town

Email

Phone number

Date of Birth

Gender

About your retreat

What is the main reason you have chosen Azur Wellness for your health retreat?

Do you have any allergies?

Comments or special needs (optional)

Are you travelling with a friend? If yes, please let us know their name(s): (optional)

Accommodation you would like:

Emergency contact name and phone number

A deposit of 175€ is required to reserve your 6 day retreat.

I Agree

CANCELLATION POLICY: Transfer to another program 30 days or more before the start date there is no charge, less than 30 days there is a 25€ admin charge. Complete Cancellation more than 30 days before the start date there is a 25€ admin charge, less than 30 days is loss of the deposit. Azur Wellness reserves the right to cancel any retreat and will re-imburse the participants payment in full.

I agree

Total

€175

Card

Card number

Expiry

CVV/CVC

Date

May 13 – 15 2022

Choose 3 or 5 days!

What’s included daily:

~ 2 x organic vegetables juices

~ 1 x organic smoothie

~ 2 x organic soups

~ packet of seeded crackers

~ recommendations

Azur Wellness

Juice & Soup Detox

Juice & Soup Weekend Booking Form

Personal Information

About your retreat

Date

Choose 3 or 5 days!

What’s included daily:

Price 50€/day

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