Embodied Zouk Retreat Sedona
May 22-27, 2019
Name *
Email address *
Phone number *
Mailing address *
How did you hear about this retreat? *
What is your overall experience with dance, zouk, yoga, movement practices, meditation, and retreats? *
Are you open to sharing a bed with another retreat attendee? (pick yes, if you are coming with your significant other) *
Dietary restrictions *
If you have any food allergies, please elaborate.
Who is your emergency contact, and what is his/her phone number? *
Do you have any injuries or medical issues that may affect your ability to participate in the activities during this event?
"As an attendee of this retreat, I claim that I am healthy and capable of participating in all retreat activities. I have my own health insurance and understand the health risks involved in any dance and/or exercise program as well as the potential risks involved in any recreational activity, and I will not hold Grand Canyon Salsa Festival, EMBODIED LLC, the retreat venue or any of its teachers or workers liable for any injuries I may incur while attending this retreat. I agree to sign a liability waiver upon arrival at retreat location." *
I understand that I will be paying a total of $1,199.00 for the Early Bird full retreat price before February 1st and $1,499.00 after this date. I can pay the full price upfront, or I have the option to set up a payment plan that must be pre-arranged. (If I have chosen this option, I will be contacted about that plan after I have submitted this registration form). All payments need to be made no later than April 30th, 2019. *
As soon as I fill out this registration form, I am officially registered for this retreat, and I plan to send my payment through Paypal to grandcanyonsalsafestival@gmail.com (Friends & Family) or via VENMO to avoid extra fees (otherwise fees will be covered by attendee) and: *
"I understand that all payments and deposits are final and non-refundable. In the event that I am not able to attend this retreat, I can sell my space to another attendee, and I realize that this is my full responsibility." *
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