Registration Form ← BackThank you for your response. ✨ Name(required) Email(required) Phone How did you hear about this retreat? Other Details Accommodations, Single room or shared room? There are a few rooms with 3 beds as well. Please also state if you prefer to be with someone you are traveling with. Submit Δ ← BackThank you for your response. ✨ Accommodations. Single room or shared room. There are a few rooms with 3 beds as well. Please state also if you prefer to be with someone you are travelling with. (required) Emergency Contact required) Emergency Contact Phone Number All vegetarian meals are included. Any dietary restrictions? Other Details Submit Δ ← BackThank you for your response. ✨ I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives will not make a claim against, sue or attach the property of The Host, their affiliates, teachers, employees, agents or volunteers or any of their affiliated organizations for injury or damage resulting from acts, howsoever caused, by any employee, agent, or contractor, or any of their affiliated organizations, as a result of my participation in The Host’s retreats. I hereby release The Host, and any of their agents or affiliated organizations from all actions, claims or demands that I, my assigns, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury, damage, or death resulting from my participation in The Host’s retreats. I am medically, physically, emotionally and in all respects fit and able to participate in The Host’s retreats. I agree I will be fully and financially responsible for my own physical condition and well-being during the retreat and will follow the safety precautions and instructions prescribed by The Host. I acknowledge that The Host may make suggestions from time to time that are intended to help me and my well-being. However I take ultimate responsibility for my choices and realize that The Host is not licensed medical provider and that I must consult my doctor. If I experience pain or discomfort during the retreat, I will modify The Host’s instruction to suit my individual needs. I will not hold The Host responsible for any pain or discomfort I experience during or after the retreat. I understand that the activities offered on this retreat are not a substitute for medical care. I understand that The Host is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness. By agreeing to the terms outlined here and elsewhere on the The Host’s website I hereby release and discharge my rights and claims for damages or liabilities that may occur as a result of participation on a The Host’s retreat. By submitting your information, you’re giving us permission to email you. You may unsubscribe at any time. SubmitSubmitting form Δ Share this:TweetMore Share on WhatsApp (Opens in new window) WhatsApp Like Loading...