New York Yoga Retreat Registration 2026

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you are committed to taking the plunge, please fill out this form. We are headed to Shandaken!

Email *

Full Name *

DOB *

YYYY

Email *

Cell Phone Number *

Billing Address *

Would you like to pay in full for the retreat $1,575 or pay in installments? *

I would like to pay in full

I would like to pay in installments

Please include your checking account number and routing number OR your credit card number, exp date, 3 digit code and billing zip code.

Please note that there is a merchant fee for credit cards and no fee for checking account.

Billing address and zip code *

Would you like a single room or shared accommodation? *

Single rooms are an additional $375

I will share a room

Emergency Contact *

Food Allergies or Dietary Restrictions *

How did you hear about us?! *

We are so excited! We hope you are too : )

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. - Terms of Service - Privacy Policy

Does this form look suspicious? Report