Illuminate - Registration
Event Timing: November 8-10, 2019
Event Address: TaoSatva, #2 Upper Las Colonias, El Prado, NM
Contact us at (575) 737-8005 or
Email address *
Name *
Email *
What 5Rhythms or other conscious dance practice do you have? Please include the names of the teachers you have worked with. *
What other forms of meditation, movement or art practice do you have? *
Who is your emergency contact? Please include name, phone number, and physical address. *
Please acknowledge the following workshop agreements:
Clear selection
Agreement of Release and Waiver of Liability That I am participating in this workshop offered by Mystery in Motion & Visudha de los Santos during which I will move my body, and receive instruction and guidance about movement as meditative practice. I recognize that dance movement requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I represent and fully warrant that I am physically fit and I have not medical conditions that would prevent my participation in classes and workshops. I further hold Mystery in Motion & Visudha de los Santos harmless from any indemnity. By checking the box below I agree to this release and waiver of liability.
I understand that I will go to to pay my fee electronically ($195 Standard, 0r $165 early by October 20th.) , or mail payment to PO Box 2686, Taos, NM 87571 *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy