Enchantment & Awe: A Retreat to Yoga and Nature in Costa Rica

Yoga Retreat Registration Form

Thank you for registering for a retreat with Namastacey Yoga. Please provide the following information here - once I have received your form I will contact you with more information.

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Date of Birth
Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Phone Number*
Please list an dietary restrictions and known allergies to food or medicine.
Do you have any physical injuries or limitations. Please explain.
List any medication you are taking.
Room Selection (Based on Availability)
If you are choosing a double, please specify your roommate request if you have one and indicate if you are a couple.

If you are traveling solo and would like a roommate we will do our best to find you a match.
A non-refundable deposit of $500 is required to hold your spot.
Once we receive this registration form, we will contact you for payment.
Checks, Venmo or Zelle are preferred methods of payment. A fee will be added for credit card payments.
The trip must be paid in full by January 15, 2025.
SAVE $200 If you pay in full by December 1, 2024.
Terms and Conditions*
I accept the terms and conditions stated below.
Click here to Read Terms and Conditions / Liability and Release
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Enchantment & Awe: A Retreat to Yoga and Nature in Costa Rica

Yoga Retreat Registration Form

COPYRIGHT 2023 STACEY ROSENBERG

GIFT CARDS BLOG STORE RESOURCES TEACHERS

Yoga Retreat Registration Form

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COPYRIGHT 2023 STACEY ROSENBERG

GIFT CARDS BLOG STORE RESOURCES TEACHERS