Registration Form | Quantum Wellness

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Quantum Retreat Costa Rica 2024

Full name (As shown on passport) .... First name

Last name

Middle Name (s)

Date of Birth

Passport Expire Date

Street Address

City

Region/State/Province

Postal / Zip code

Country

Code

Phone

Email

Accomodation Type

Please let us know of any severe allergies and/or dietary restrictions. WE CANNOT GUARANTEE THAT WE WILL BE ABLE TO ACCOMMODATE ALL DIET TYPES. MEALS WILL BE A MIX OF VEGETARIAN AND/ NON-VEGETARIAN MEALS.

Payments will be processed over the phone within 24-hours of registration by our TICO certified travel agent.

Terms & Conditions

I have read & agree to the terms & conditions

Thank you for registering.See you in Costa Rica!

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Send Message

Thanks for submitting!

Contact Info

613-805-0274

info@yourquantumwellness.org

© 2023 by Quantum Wellness.

All Rights Reserved.

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