Bell Valley 2022 Registration ~ Rosemary Garrison Yoga

Personal Information

Name*

First Last

Email*

Enter Email Confirm Email

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Housing

Room Selection*

Platform tent/ Double - $1,075 before July 1st/ $1,275 after July 1st, 2022
Bunkhouse/ Dorm: $1,275 before July 1st/ $1,475 after July 1st, 2022
Main House/ Double: $1,975 before July 1st/ $2,175 after July 1st, 2022
Main House/ Single: $2,775 before July 1st/ $2,975 after July 1st, 2022

Payment Option*

Yoga Experience & Interest

Level of Yoga Practice*

Beginner / less than 100 practice hours
Intermediate / 100-1000 practice hours
Advanced / over 1000 practice hours

Are you a yoga teacher?

Yes
No

Would you like to receive information on future Teacher Trainings?*

Yes
No

Would you like to receive information on future Retreats?

Yes
No

Medical Information

Are you under the care of a physician and/or chiropractor for any physical or medical condition?*

No
Yes

Please Explain:*

Do you currently have any injuries or health conditions?*

No
Yes

Please Explain:*

Dietary Information

Do you have any dietary restrictions?*

No
Yes

Please Explain:*

Emergency Contact Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Relationship*

Additional Message / Information

Yoga retreat pricing above includes lodging, all meals, and related taxes and fees; airfare/transportation costs are not included in retreat pricing. Retreat deposits are non-refundable; in the event of a cancellation made prior to July 1st, 2022, your entire payment will be refunded less the $295 deposit.

Your signature below certifies that the information provided herein is true and correct, and that you accept the outlined pricing and terms of participation in the Rosemary Garrison Yoga Retreat on August 4th-7th 2022, at Bell Valley Ranch, Anderson Valley, CA.

Acknowledgement*

I Agree to the Terms of the above Agreement of Release & Waiver of Liability

Your participation in this retreat may include photographs on a few occasions. Your signature certifies that you release the use of these images to Rosemary Garrison Yoga for use with marketing and design.

Acknowledgement*

I agree to the Terms of the above Media & Copyright Agreement

Signature*

Total

$0.00

Comments

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Bell Valley Retreat 2022

Personal Information

Housing

Yoga Experience & Interest

Medical Information

Dietary Information

Emergency Contact Information