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Retreat Attendee Registration Form
Costa Rica 2023
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Full Name
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Street Address
*
Your answer
City, State, Zip
*
Your answer
Occupation
Your answer
Emergency Contact Name & Relationship
*
Your answer
Emergency Contact Phone
*
Your answer
Please indicate your level of experience with Yoga (5 =s highest level of experience)
*
0
1
2
3
4
5
Health/Medical conditions that may affect you or your yoga practice?
*
Your answer
Dietary restrictions/allergies?
*
Your answer
Anything else you would like to share with me about yourself, your experience, your expectations, or your current journey?
Your answer
Accommodations:
*
Single Occupancy KING
Double Occupancy KING shared
Twin
Required
TOTAL PAYMENT DUE * A non-refundable deposit of 20% of your selected room is required to secure your space. Payment link will be sent to you once form is submitted. Please see the retreat web-page for full details. Retreat must be paid in FULL by November 30, 2021. Please initial agreeing to this policy
*
Your answer
CANCELLATION & REFUND POLICY :: If you've paid in full prior to November 30th, you will receive a refund minus your 20% deposit. If you cancel your reservation on or after November 30th; no refund can be given. (Cancellation must be received in writing via email.) *Please initial below that you have read and understand this cancellation policy.
*
Your answer
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