2019 Costa Rica Retreat Registration
Yoga, Nature & Pura Vida! July 29-August 5, 2019
Email address *
First & Last Name: *
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Today's Date: *
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Phone Number & Any Alternate Phone Number(s): *
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Mailing Address: *
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T-shirt Size: *
Accommodation Choice: *
Note: If you select "Shared," you must secure your roommate prior to registration.
**If you selected "Shared" for your accommodation type, please name your roommate with whom you'll share the bed:
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Meal Preferences or Dietary Restrictions: *
Please indicate any types of foods you do not eat (including allergies) or any diet you adhere to, whether it's all the time or only for some of your meals. This will be essential in choosing the meals you will be provided, including during our restaurant excursions.
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Please indicate any relevant health conditions that may affect you or other guests you will be sharing a casita and villa with. *
Note: We will be staying in temperatures between 70-85 degrees F in rural mountains and tropical jungle, engaging in optional physical activities (horseback riding, light to moderate hiking with hill climbing, yoga in nature, etc.) and walking on paved and semi-rugged paths.
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List 2 emergency contacts with their names, phone numbers, emails and state/country of residence: *
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What is your length and type of experience with yoga and meditation, if any? *
All levels and styles of yoga and meditation experience are welcome.
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Estimate your level of physical fitness. *
While our retreat locations are in tourist-friendly sites, this retreat includes various levels of optional daily physical activity in a foreign country, where your immune system may be challenged with new foods and environment. Your information will help us to advise you on how to prepare for your trip.
Explain your intention for joining this retreat, "Yoga, Nature & Pura Vida!" *
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Please read our Cancellation Policy and type your name as your signature of agreement below. Root 2 Rise Yoga, Michelle Chua and their affiliates in Costa Rica will do their best to facilitate an enjoyable inspiring yoga, culture and adventure retreat abroad. In rare unforeseen circumstances, plans may change. The following outlines Root 2 Rise Yoga’s cancellation policy: 1.) Should you choose to cancel your participation in this retreat, you must state it in writing via email to Root2RiseYoga@gmail.com. 2.) The first $500 of your payment is non-refundable and non-transferable. 3.) If you cancel by June 15, 2019, your payment minus the $500 deposit will be refunded. 4.) If you cancel after June 15, 2019, there is no refund. 5.) In the unlikely case that Root 2 Rise Yoga, Michelle Chua or their affiliates in Costa Rica cancel this retreat due to unforeseen uncontrollable circumstances, your payment will be fully refunded. Prior to such cancellation, other similar accommodations or options within the retreat area will be explored and proposed to you. Michelle Chua and Root 2 Rise Yoga are not responsible for your expenses incurred in preparation for any canceled retreat. These may include airline tickets, loss of work, or other costs associated with preparing for your trip. Please type your full name below as your signature of agreement to these terms. *
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Please read our Liability Waiver and type your full name below as your signature of agreement to these terms: While Root 2 Rise Yoga and Michelle Chua prioritize your safety above all, there are inherent risks involved in traveling and participating in physical activities, such as yoga, outdoor adventure and recreation. These risks are not limited to damage or loss of personal belongings and personal injury. By signing below, you, the retreat participant, state that you are in satisfactory health and suffer no physical impairment to voluntarily participate in the yoga sessions, outdoor adventure and recreation per retreat description. You accept and assume all risks existing in those activities and in traveling within Costa Rica. You agree to research the risks of those activities and of travel for which you are not aware. You agree to inform Michelle Chua and Root 2 Rise Yoga in writing of any allergies, dietary needs or preconditions that may affect your and others’ safety and well being. You are responsible for bringing sufficient medications or health aids you may need in a manner that is legally approved for international travel and within Costa Rica. You and your associates (i.e., family, friends, etc.) voluntarily waive any claim to maintain a lawsuit or demands of any kind against Root 2 Rise Yoga, Michelle Chua, their staff and their affiliates in Costa Rica, including where you will be hosted, for any injury, illness, death, accident or loss or damage of personal property, which may occur during your participation on a yoga, culture and adventure retreat abroad. We recommend that all participants purchase travel insurance that covers emergency medical care, cancellation of flights and for loss or theft of personal items. *
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Please indicate the payment amount and means of payment that you will submit to secure your registration. Payments are accepted via cash, cashier's check, PayPal or credit card, the latter two accruing a 3.5% service charge. Checks can be made payable to "Root 2 Rise Yoga" and mailed to: 3940 Laurel Canyon Blvd. #313 Studio City, CA 91604. Please submit payment only after your registration has been accepted and space availability is confirmed. *
$500 is your non-refundable, non-transferable deposit. *By June 30, 2019, full payment amount is required to hold your space on this retreat.
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Thank you for your interest in joining us in Costa Rica!
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