2023 Wild Women's Retreat 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 - $1,175 before August 21st/ $1,375 after August 21st, 2023
Platform tent/ Single - $1,475 before August 21st/ $1,675 after August 21st, 2023
Bunkhouse/ Dorm: $1,375 before August 21st/ $1,575 after August 21st, 2023 - SOLD OUT
Main House/ Double: $2,075 before August 21st/ $2,275 after August 21st, 2023
Main House/ Single: $2,875 before August 21st/ $3,075 after August 21st, 2023

Platform - Double*

Platform - Single*

Bunkhouse/Dorm*

Main House - Double*

Main House - Single*

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 August 21st, 2023, your entire payment will be refunded less the $395 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

Phone

This field is for validation purposes and should be left unchanged.