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 *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Best Phone Number to Reach You *
Your answer
Mailing Address
Your answer
Social media handles (Facebook & Instagram)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender Identity
Your answer
Your Occupation
Your answer
Dietary preferences *
Your answer
Do you have any medical conditions or injuries that we should know about? (If not, please write in N/A) *
Your answer
Please list all allergies, including any food allergies. (If not, please write in N/A) *
Your answer
What do you hope to get out of this New Year's Adventure?
Your answer
Do you practice yoga/ meditation? If so, for how long and any particular styles?
Your answer
Do you spend time engaged in any activities that support your physical health and/or emotional wellness? Any hobbies or favorite past times?
Your answer
Which type of rooming situation are you interested in?
If you are registering with someone who will be your roommate, please give their full name:
Your answer
Please tell us how you heard about this retreat?
Your answer
Is there anything else you think we should know about you?
Your answer
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
Preferred payment method - full payment (amount based on room choice minus deposit)
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