PreForm - Dead Sea Yoga Retreat

avayasana Retreat Registration Form

Name *

First

Last

Email *

Phone *

Please indicate your experience or level (1-10) 10 being highest level, or most experience:

Yoga experience

Selected Value: 0

Meditation Experience

Selected Value: 0

Your age:

Under 40
40-60
Over 60

Diet restrictions / preferences / allergies (vegetarian, vegan, wheat, etc.) :

Health / Medical condition we should know about:

I represent and warrant that I am in good physical health and do not suffer from any medical condition which would limit my participation in the AVAYASANA retreat. I understand that it is my responsibility to consult with a physician prior to my participation in any of the yoga classes, programs, or workshops and any activity offered by the AVAYASANA retreat on and off the water. I understand the risks associated with the activities offered and I agree to follow all instructions so that I may safely participate in classes, workshops, or other activities on the ground or on the water. I hereby waive and release the AVAYASANA retreat along with its representatives, employees, and instructors from any claim, demand, or cause of action of any kind resulting from or related to my participation in the programs offered through the AVAYASANA retreat. In taking part in the yoga classes, workshops, or other activities and workshops/classes/activities done with the AVAYASANA retreat in any location, I understand and acknowledge that I am fully responsible for any and all risks, injuries, or damages, known or unknown, which may occur as a result of my participation in the classes, workshops or other activities. I have read the above release and waiver of liability and fully understand its content I am legally competent to sign and voluntarily agreed to the terms and conditions stated above. Please practice mindfully and enjoy the many benefits of practicing yoga and meditation with AVAYASANA.. *

Check this box to indicate that you agree to the release form