REGISTER

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the reset retreat

 

Please review the information on the retreat page including dates, costs, & curriculum for this retreat and fill out the information below.

Note: All information provided in this application is for school use only and will be used to determine eligibility for the specific program you are interested in. All information will be held in the strictest confidence and will not be shared externally.

Dates: april 13–19, 2019


 
 

ADMISSIONS CRITERIA *

You must be at least 18 years of age to participate in this retreat.

GETTING TO KNOW YOU

Please answer the questions below honestly and completely. If you have any further questions please email info@awakenedspirityoga.com.
Legal Name *
Legal Name
Full Address *
Full Address
Phone Number *
Phone Number
Date of Birth
Date of Birth
Emergency Contact
Emergency Contact
Emergency Contact Phone Number
Emergency Contact Phone Number
Emergency Contact Cell Number
Emergency Contact Cell Number

Related Experience

How long have you been practicing yoga?
Within the past year how many times, on average, do you practice per week?

Health Information

Please indicate if you currently have or have a history of the following conditions in your lifetime:

Short Answer

PROGRAM WAIVER *

I acknowledge that all information submitted in this application is true and accurate. I have read the criteria listed above, and understand that it is my responsibility to consult with a physician regarding my participation in this retreat. I am physically fit and I have no medical condition that would prevent my participation in the training. I take full responsibility for my own pacing of what I can and cannot do during the course. I understand that the retreat activities are voluntary and I will honor my wellbeing by not pushing myself beyond my capacity. I assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the Reset Retreat. I will not hold any of the facilitators for this training responsible for any injuries or actions arising out of, or in any way connected to my participation in this program. I acknowledge that a risk of personal injury may be involved in any exercise, yoga or dance program, and understand that it is my responsibility to refrain from performing any postures or exercises that cause me pain or discomfort, physically or emotionally. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue or make any claims of any kind whatsoever against Awakened Spirit Yoga or any of the aforementioned parties for any injury, property damage/loss, or death caused by their negligence or other acts.