Pyramid Retreat: Jan 25-Feb 5, 2022

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After submitting your $250 deposit, please complete this registration form.

Email *

Name *

Today's Date *

YYYY

Address *

Phone number *

Pyramid Option Preference: (First come, first serve) - We will let you know if your preference was available when you submitted this form, and what your final balance is by April 30, 2021. *

Tier One: smaller (2 bedrooms, 1 bathroom) $1495

Tier Two: larger (2 bedrooms, 2 private baths) $1615

Don't care. Give me whatever is available.

How would you like to pay your final balance? *

Pay balance with credit or debit card by October 15, 2021

SAVE AN EXTRA $25 by making a direct fund transfer using Venmo or Zelle

Medical Questionnaire: Do you have any medical condition, health limitation, injury or recent surgery that we should be aware of? *

Emergency Contact (Name, Email & Phone) *

Will you be using the group transportation? *

Yes, I will be be using the group transportation

No, I will have or rent my own vehicle

Contract & Liability Release *

I understand that I am registering for a retreat that will include travel and group exercise

I take full responsibility for my own safety and health

I agree that purchasing medical and/or travel insurance are my personal responsibility

I release the facilitators and property owners from any liability for my healthcare

I release the facilitators/property owners from liability in the case of injury during exercise

I understand that this retreat is self-catering and I am responsible for my own meals

I agree to pay a non-refundable deposit of $250, and the balance by 10/15/21

I understand that registration is first come, first serve and that I may not get my preferred option

I understand that this is a "healing retreat" and will not come to group activities intoxicated

I understand that diversity inclusion and anti-discrimination are the values of these facilitators.

I will provide the facilitators with my travel itinerary by January 15, 2022

Required

Do you have a request to share a pyramid with a specific person? If yes, what is that person's NAME and EMAIL address? (If they are not on this invitation list, if space is still available shortly, we will send them an invite to register too)

Do you have any questions or want to tell us anything else?

A copy of your responses will be emailed to the address you provided.

Submit

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