Caribbean Yoga Retreats

 

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Retreat Registration
*Required Fields
*Full Name:
*Gender: Female
  Male
*E-mail:
Address:
City, State Zip Code:
Birthdate (mm/dd/yyyy):
*Day Phone:
Evening Phone:
*Occupancy: Private
  Shared
Name of the person you are sharing with:
Retreat:

Breathe, Power, and Grace
Meditate, Relax, and Rejuvenate

*Emergency Contact Name
(Someone not traveling with you):
*Emergency Contact Number

Special Dietary Needs:
Have you been hopitalized for any reason in the past 6 months? If so, why?:
Physical conditions that might affect your ability to do yoga:
Yoga experience and level: What style(s) do you normally practice? How many years have you been practicing? How frequently do you practice?:
How did you hear about this retreat?:
What do you hope to get out of this retreat?
FREE T-SHIRT! What Size? S
  M
  L
  XL

 

RELEASE OF LIABILITY
I recognize that yoga and fitness training requires physical exertion which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I also understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Caribbean Yoga Retreat, Inc., retreat and all of its classes and activities. I represent and warrant that I have consulted with a physician and that I am physically fit and I have no medical condition which would prevent my participation in any of these activities.

As a condition of being permitted to participate in the Caribbean Yoga Retreat program and activities, I agree to release, hold harmless and indemnify Caribbean Yoga Retreats, Inc., its owners, agents and employees (hereinafter “Releasees”), on my own and on behalf of my heirs, executors and assigns, from any and all claims for personal injury, death or property damage, including those caused by the negligence or other fault of Releasees. I agree to assume all risks associated with my participation in the retreat and its program and activities. I agree that any claim or suit that I, or my representatives bring against Releasees, must be brought exclusively in the Parish of Christ Church, in The Supreme Court of Judicature, High Court of Barbados and the laws of Barbados shall govern. If any portion of this agreement is deemed unenforceable, all other parts shall remain in full force and effect. I intend this document to be interpreted as broadly as permissible by Caribbean law.

I Agree