Wholehearted Harmony, Women's Retreat with Michelle Chua
Dates: Sunday, October 10, 2021
Location: Private Garden in Malibu, CA
(818) 235-9067 or Root2RiseYoga@gmail.com
Sign in to Google to save your progress. Learn more
Email *
Name *
Email *
Phone Number *
Please share your intention for joining this retreat. *
Date of Registration (includes when retreat payment will be received) *
MM
/
DD
/
YYYY
Dietary restrictions (Our meals will be organic and vegan.) *
Please list 2 Emergency Contacts, including their full name, phone number, emails and relationship to you. *
Please read our CANCELLATION POLICY and TYPE YOUR FULL NAME BELOW as your signature of agreement. Michelle Chua and Root 2 Rise Yoga will do their best to facilitate an enjoyable inspiring yoga and wellness retreat at the private garden in Malibu, CA.  If you choose to cancel your participation in this retreat, your registration payment is non-refundable and nontransferable. In the unlikely case that Michelle Chua or Root 2 Rise Yoga cancels this retreat due to unforeseen uncontrollable circumstances, your payment will be fully refunded.  Prior to such cancellation, other similar accommodations or options within the retreat area will be explored and proposed to you.  Michelle Chua and Root 2 Rise Yoga are not responsible for your expenses incurred in preparation for any canceled retreat.  These may include airline tickets, loss of work, or other costs associated with preparing for your trip. Please type your full name below as your signature of agreement to these terms. *
Please read our LIABILITY WAIVER and TYPE YOUR FULL NAME BELOW as your signature of agreement to these terms:  While Root 2 Rise Yoga and Michelle Chua prioritize your safety above all, there are inherent risks involved in participating in physical activities, such as yoga in nature, outdoor hiking and recreation.  These risks are not limited to damage or loss of personal belongings and personal injury.  By typing your full below, you, the retreat participant, state that you are in satisfactory health and suffer no physical impairment to voluntarily participate in the yoga sessions, outdoor activities and recreation per retreat description.  You accept and assume all risks existing in those activities and in visiting the private garden in Malibu, CA.  You agree to research the risks of those activities for which you are not aware.  You agree to inform Michelle Chua and Root 2 Rise Yoga in writing of any allergies, dietary needs or preconditions that may affect your and others’ safety and well being.  You are responsible for bringing sufficient medications or health aids you may need in a manner that is legally approved to the retreat.  You and your associates (i.e., family, friends, etc.) voluntarily waive any claim to maintain a lawsuit or demands of any kind against Root 2 Rise Yoga, Michelle Chua or the owners of the private garden and home in Malibu, CA, where the retreat will be held, for any injury, illness, death, accident or loss or damage of personal property, which may occur during your participation on this Yoga in Nature Retreat.   (Type your full name below.) *
Please select your method of payment to offer energy exchange for this retreat.  Submit payment only after your registration has been accepted and space availability is confirmed.  Canceled checks will incur any fees charged to Michelle Chua. *
Clarify the amount you are submitting, according to the date your payment will be received, to reserve your spot on this retreat. *
Carpooling is highly recommended, as we have only 11 parking spots maximum for our retreat guests.  If you would like to receive a group email to help you coordinate carpooling with another guest, please indicate the city from which you'll be traveling and whether or not you are willing to drive.  
Thank you for choosing to join us!  Find our retreat info at: Root2RiseYoga.org/Womens-Retreat
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy