Celebration!  A Women's Holistic Health Retreat
Event Timing: Saturday, March 18, 2023 from 1:00-4:30pm
Event Address: Marshall Community Center, Large Meeting Room
                           4133-A Rectortown Road, Marshall, VA  20115

Pricing*:
$150 - solo adults (20 and up)
$200 - adult (20 and up) with teen (ages 14-19).  One registration per person including teens.  We want to hear from all you attending so we can think well about you. 

$75 -  seniors, full-time students, teachers, veterans of active duty, first responders
$100 - discounted adult (20 and up) with teen (ages 14-19)


*No one will be denied due to funding.  Contact Unyong at (703)919-7202 or info@stressburneryoga.com

Please bring a yoga mat and wear comfortable exercise attire.  For ages 14 and up.

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Email *
Name *
Teen's Name (if coming)
Phone Number *
Address *
Emergency Contact & Relationship to Participant(s) *
Emergency Contact's Phone Number *
Medical Notes (ie: Allergies, Exercise Restrictions) *
Hold Harmless

Stress Burner Yoga/Unyong Kim and Partners Fitness and Nutrition/Natasha Frisk, Mary Shapiro and Heidi Lyons, (henceforth referred to as Partners) is presenting "Celebration! Women's Holistic Health retreat" as an activity to enhance individual wellness.  By signing below, you assume full responsibility for all liability and risks associated with your (and your minor's) participation in the retreat.  To the greatest extent allowed by law, you indemnify, hold harmless, release, discharge and promise not to sue Stress Burner Yoga and Partners for any liability, losses, damages, claims, demands, expenses or injury arising out of your participation in the retreat.  You acknowledge that you are physically able to participate in the program, and you have read this release agreement and fully understand its terms.

have read, understood, and agree to be bound by the above Hold Harmless statement. *
Required
Photo Release

Permission is granted to Stress Burner Yoga and Partners to use photographs of students/participants for publicity and education purposes consistent with the mission of Stress Burner Yoga and partners. I hereby assign full copyright of photographs and video/audio recordings of me/my child(ren) taken during programs administered by Stress Burner Yoga, and Partners of STRESS BURNER YOGA with the right of reproduction either wholly or in part. I understand and give my permission to use my/my child(ren)'s name, likeness, image, voice, and/or appearance represented in any illustrations, pictures, photos, video/digital/audio recordings, digital images, taken or made on behalf of Stress Burner Yoga and Partners. I understand that I will not receive any compensation for the use of the publicity materials and hereby exempt, release, and indemnify Stress Burner Yoga and Partners from any and all liability or claims pertaining to use of publicity materials.

have read, understood, and agree to be bound by the above photo release statement. *
Required
How did you hear about the retreat?
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I understand that my place is not reserved in the workshop until the fee is paid. *
Required
What made you decide to register for the retreat?  What would you like to get out of it? *
Amount paid
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