REGISTRATION FORM Yoga Retreat in ITALY
Program Runs: Aug 17-25, 2020
First and Last
What best describes you?
I am new to yoga and looking to explore it more.
I have a yoga practice and I'm looking to dive deeper into it.
I am a certified yoga instructor looking to practice, relax and connect.
If you know the name of another yogi attending the program whom you would like to room with, please list their NAME and EMAIL below:
Registration Payment Info:
There is a $500 non-refundable deposit to reserve your spot in the program. The remaining balance due will be collected in April/May. If you need to withdraw after final payment, 50% of your remaining fees will be returned.
I will complete my $500 deposit to reserve my spot and understand the remaining fees will be due in April/May.
I am applying for a scholorship and would like to request a payment plan option.
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
How did you hear about this program?
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