December 2022 Wellness Retreat with Michelle Chua & Root 2 Rise Yoga
(1-Day or 4-Day) INNER PEACE, OUTER HARMONY near Temecula, CA
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Email *
Today's Date: *
First & Last Name: *
What's your best email to contact you about this retreat? (Please check your spelling.) *
Best Phone Number to Reach You: *
Are you registering for the 4-day or 1-day retreat? *
Explain your intention for joining this wellness retreat, "Inner Peace, Outer Harmony," with Michelle Chua. *
FOR DEC. 3-6: Choose your accommodation occupancy type.
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FOR DEC. 3-6: If you chose SHARED or DOUBLE and if available, would you like to request a cot or sofa bed and receive the $50 discount?  
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FOR DEC. 3-6: If you chose SHARED (triple only) or DOUBLE occupancy, name the other guest(s) who will be your roommate.  Each person must complete a separate registration form.  After all roommates have registered, then you'll be able to reserve your room, pending availability.
FOR DEC. 3-6: What is your 1st choice of preferred rooms?  You will be contacted and presented with what's available at your time of registration.
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FOR MAY 6-9: What is your 2nd choice of preferred rooms? You will be contacted and presented with what's available at your time of registration.
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Allergies & Dietary Restrictions: List any allergies and dietary restrictions you have, if any.  All meals are vegan. *
List 2 emergency contacts with their names, phone numbers, emails and state/country of residence: *
What is your length and type of experience with yoga, mindfulness and meditation, if any?   *
All levels, including beginners, and styles of physical yoga and meditation experience are welcome.  
How did you learn about this retreat? *
CANCELATION POLICY:

• Participant cancellations received in writing at Root2RiseYoga@gmail.com by November 1, 2022 are refundable, minus $250 USD of the total retreat investment.

• After November 1, 2022, the full balance is nonrefundable and non-transferable.  

Consider purchasing travel insurance if you are purchasing flights to attend this retreat.

DO YOU UNDERSTAND & AGREE TO THIS CANCELLATION POLICY?
 *
LIABILITY WAIVER:

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, outdoor hikes/nature walks and retreat activities.  These risks are not limited to damage or loss of personal belongings and personal injury.  

By signing 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 hikes/nature walks and activities listed on the retreat itinerary (at Root2RiseYoga.org/peace).  

You accept and assume all risks existing in those activities and in staying at Ojas Retreat Center.  

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 legal medications or health aids you may need during your stay.  

You agree to cancel your attendance at the retreat if you have flu or COVID-19 symptoms within 1-3 days of the retreat dates.  

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, their staff and their affiliates at Ojas Retreat Center for any injury, illness, death, accident or loss or damage of personal property, which may occur during your participation on a wellness retreat.  

DO YOU UNDERSTAND AND AGREE TO THIS LIABILITY WAIVER?
 *
COVID-19 PRECAUTION: 

Within 48 hours prior to your retreat start date and time, you may be required to present proof of negative test results for COVID-19.  At least 2 weeks prior to the retreat, you will be informed by email if this is required.

DO YOU UNDERSTAND & AGREE TO THIS COVID PRECAUTION?
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PAYMENT PROTOCOL: 

After submitting this form, you will be contacted by email to confirm availability of your accommodation choice and receive options to submit your $250 deposit or full investment, the latter due by November 1, 2022. 

Payment methods include cash, check, Zelle and credit card (add 3.5% to your amount for the latter). 

To hold your spot on this retreat, the amount due must be received within a week of your (and your roommates', if applicable) submitting this registration form.  

To ensure our email notification does not get lost in your spam folder, please add Root2RiseYoga@gmail.com to your preferred contacts list in your email account.
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DO YOU UNDERSTAND & AGREE TO THIS PAYMENT PROTOCOL?
Thank you for your interest in joining us for INNER PEACE, OUTER HARMONY Wellness Retreat! By clicking SUBMIT below, you are agreeing to the terms and conditions listed in the above sections of this form. Please check your email for a response within 1-3 business days after submitting this form.
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