InGreenPeace Nourish The Soul Intake Form & Contract

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InGreenPeace.com - Nourish the Soul Retreat

Frio River

Passport Expiration Date?

YYYY

Who did you place your deposit with (if you have) and who told you about this camp?

Name *

Email *

Address

Phone number *

INJURIES/CONDITIONS:
*

EMERGENCY CONTACT:
*

TREATMENTS/MEDICATIONS:

INDIVIDUAL GOALS:

Food allergy and/or restrictions?

Do you consent to being photographed for InGreenPeace.com & Divine Associates website/social media pages?

Yes

No Thank you

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DISCLAIMER:

I understand the various risks associated with an exercise program, retreat or event and it is my desire to participate. I have not withheld any relevant information regarding my physical condition, which may affect me during or following a session. I agree that Ingreenpeace.com, Divine Moon Yoga, Stryker Corp. are not responsible for any injuries sustained by me during my retreat and hereby release them from any responsibility.

Our business operates on a scheduled basis. When cancelling a retreat/workshop/camp, we require all customers to provide two weeks notice to the scheduled retreat for 50% refund. Otherwise, we will charge customers 100% of the retreat cost. If customer can provide emergency circumstances there will be exceptions to this rule.

Please place your payment with us via Pay Pal, Venmo, Cash App or through our booking system on the website.

Venmo.com/ingreenpeace

Cashapp: $leahyoga

Paypal.com/leahmurray617

I have read and understand the policies and procedures.

By entering yes, followed by your name below you are digitally signing and agreeing to these procedures:

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