REGISTRATION FORM Yoga Retreat in ITALY
Program Runs: Aug 17-25, 2020
Name *
First and Last
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Email *
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Phone *
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What best describes you? *
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:
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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.
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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