REGISTRATION FORM Yoga Retreat in ITALY
Program Runs: Aug 10-25, 2018
Name *
first and last
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Email *
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Phone *
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What best describes you below: *
Accommodation *
The apts provided by the program for the 2 weeks are 350 euros. Generally 2 people per room. A smashing deal, we know! (You will pay for apartments in euros when we arrive on 8/10/18. You can exchange this money in the US or at the airport when you arrive in Italy)
If you know the name of another yogi attending the program you would like to room with please list their NAME and EMAIL below:
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Registration Payment Info: DUE: APRIL 1 *
Mailing Address: Amalgamate Dance Company, 200 Bennett Avenue #4h, New York, NY 10040
Your e-signature below signifies that you have read and agree to the following: I hereby release Amalgamate Dance Company (ADC), its instructors, directors, technical crew and all class, and event locations from any liability due to personal injury or loss of property, which I may sustain as a result of participating in any activity with the Company. Part II Photo/Video Waiver: I hereby give permission to Amalgamate Dance Company to use photographs and video that I submit to the company for use on ADC's Website and/or within any other promotional materials. As well, as photographs and video taken of me while participating in the program. Thank you! THE YOGA RETREAT & ADC TEAM *
(full name)
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How did you hear about this program? *
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