Registration Form
Meditation and Yoga Retreat, 20-24 June 2022, at Anand Ashram Ubud
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Email *
Full Name *
Sex *
Mobile/WhatsApp Number *
Age *
Profession *
Home City and Country *
Nationality *
Chosen Accommodation *
Have you ever joined or practiced any kind of yoga, meditation or pranayama? Please explain if your answer is yes. *
Are you having any physical/mental/emotional health issue, e.g. asthma, epilepsy, heart problem, back pain, walking difficulty, pregnancy, PTSD, etc? Are you taking any prescribed medicine for any ailment or health condition? *
Additional information you would like to add
Please READ IMPORTANT NOTES BELOW.
I am participating in this program in my own interest and take full responsibility for my participation. I will not engage in any activity which is not befitting or is derogatory to the manners/conduct expected in the ashram, thus abiding by the ashram discipline as well.

I agree that meditation is not religion and not a substitute to any medical/non-medical treatment. I understand that my enrollment in this program is at my sole risk, and that Anand Ashram and its management and facilitators are neither responsible nor liable for any direct, indirect, incidental, consequential, special, exemplary, punitive or other damages arising out of or relating in any way to the program, and therefore I free them from any legal consequences and lawsuits and waive all rights to compensation in case of injury or loss of any kind.

I declare that I am physically and mentally able to participate in this program. I understand that Anand Ashram does not provide any kind of insurance cover during my stay and I need to arrange my own medical or any other insurance. I understand that contribution for this program is not refundable.
A copy of your responses will be emailed to the address you provided.
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