New Year's Retreat: Registration Form
Hey friends! We are so happy that you are joining us for this adventure. Please fill in this form so that we can learn more about you and get you fully registered!

If you haven't quite made up your mind about joining or have any questions at all - do not hesitate to reach out to Sarah Block, Retreat Coordinator at sarblock418@gmail.com or 845.325.0200.

See You In The Sand!!!

Hawah Kasat, Retreat Leader
Sarah Block, Retreat Coordinator & Guest Teacher
About you!
First Name *
Last Name *
Email Address *
Best Phone Number to Reach You *
Mailing Address
Social media handles (Facebook & Instagram)
Date of Birth
MM
/
DD
/
YYYY
Gender Identity
Your Occupation
Dietary preferences *
Do you have any medical conditions or injuries that we should know about? (If not, please write in N/A) *
Please list all allergies, including any food allergies. (If not, please write in N/A) *
What do you hope to get out of this New Year's Adventure?
Do you practice yoga/ meditation? If so, for how long and any particular styles?
Do you spend time engaged in any activities that support your physical health and/or emotional wellness? Any hobbies or favorite past times?
Which type of rooming situation are you interested in?
Clear selection
If you are registering with someone who will be your roommate, please give their full name:
Please tell us how you heard about this retreat?
Is there anything else you think we should know about you?
Payment info!
Please let us know how you would like to submit the deposit and full payment. We will follow up with you with details on how to submit payment for each method.

*A $500 deposit is due upon registration to secure your spot on the retreat (spaces are limited). This deposit is fully refundable until September 15th. After which it is 50% refundable until Nov. 1st.*

**If you cannot pay the full cost upfront, please mark "other" and we will follow up with you about payment plans.**
Preferred payment method - Deposit
Clear selection
Preferred payment method - full payment (amount based on room choice minus deposit)
Clear selection
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