Osho Bodhisattva Retreat Participation Form
Please fill in the entire form so that we do all the required formalities up front.
Text us at 786.660.2260 or email at oshomiami@gmail.com for clarifications.
Reservation is confirmed only after the payment is received.
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Which retreat are you registering for?  *
Your Full  Name *
Email Address *
To send important information about the camp
Your city *
Your residence city
Your State *
Your residence state
Phone number *
Are you flying in? If so, please give us tentative date/times
We are very close to Fort Lauderdale airport. If you are coming to Fort Lauderdale international airport during regular hours, we will be able to pick you and drop you off.  

Please list any physical conditions (surgery, illness, injury, disability) - Type None if not applicable *
Emergency contact
Please provide us with a person who we may contact in the case of emergencyUntitled Title
Emergency Contact - Name
 *
Emergency Contact - Phone number
 *
Event Agreement and Liability
PLEASE READ CAREFULLY:  I agree to assume full responsibility for not exceeding my personal physical limits during my participation in the meditations. It is my responsibility to ascertain that there is no medical reason to prevent my participation in meditations and celebration. I understand that I will take care of myself, my health, well being during the meditations. I agree to immediately notify meditation staff of Osho Bodhisattva, of any change in my physical conditions, which would result in modifications or limitations to my ability to participate in meditations and/or celebration. 

I agree to defend, indemnify and hold Osho Bodhisattva, its officers, employees, agents and volunteers harmless from and against any and all liabilities, loss, expense (including reasonable attorney's fees), or claims for injury or damages arising as a result of my attendance of the above retreat and to reimburse Osho Bodhisattva for any such incurred expenses.
To agree to the above statement, click on the checkbox below
 *
Required
Photo/Video Release 
For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of myself and the recording of my voice and the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for informational purposes I understand that the term “photograph” as used herein encompasses both still photographs and motion picture footage. I further consent to the reproduction and/or authorization by OSHO BODHISATTVA to reproduce and used said photographs and recordings of my voice, only for informational purposes. Further, I understand that others, with or without consent of OSHO BODHISATTVA may use and/or reproduce such photographs and recordings. I hereby release OSHO BODHISATTVA, and any of its associated staff, from all claims of every kind on account of such use.
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Signature - Please type your name as an agreement to the above statement.

Your name will serve as an electronic signature.

Please understand that until you have paid for your participation, your reservation is not confirmed.
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Payment Method 
If you have not prepaid for your participation, you are not registered to the event. This event has to be prepaid in full. There is no partial participation, the entire event has to be attended.
 
You can prepay via Paypal to this email address ( oshomiami@gmail.com ) - $300 - for participation in all meditation sessions, all the meals and snacks for the full 5 days.
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