Booking Form - Copal Website

Yoga Retreat Waiver Form
Name*

First NameLast Name
Date

MonthDayYear
Date
Male/Female*

MaleFemale
Age*
Email*
example@example.com
Primary Phone Number*

Area CodePhone Number
Cell

Area CodePhone Number
Instagram
Facebook
Address
City
State/Province
Country*
Zip/Postal Code
Passport Number
Passport Country
Expiration Date*
Emergency Contact Name and #*
Emergency Contact State/Province
Retreats
Retreats*
7 Day Epic Adventure Yoga and Cultural Retreat in Italia - (Hospitality added value tax of 10% - prices/person)
7 Day Adventure and Relaxing Yoga Retreat with Jeka in Paradise - (Hospitality added value tax of 10% - prices/person)
7 Day Rhythmic Flow Yoga Retreat with Mayan Jungle and Beach Adventures - (Hospitality added value tax of 10% - prices/person)
7 Day Rhythmic Flow Yoga Retreat with Mayan Jungle and Beach Adventures Holiday Special - (Hospitality added value tax of 10% - prices/person)
7 Day Ocean-Front Detox: Introduction to Ayurveda plus Yoga - (Hospitality added value tax of 10% - prices/person)
10 Day Ocean-Front Detox: Introduction to Ayurveda+Yoga, Mayan Jungle Adventures and Sound Healing - (Hospitality added value tax of 10% - prices/person)
Connecting with the Nature of Mind and Body Through Yoga and Pranayama - (Hospitality added value tax of 10% - prices/person)
7 Day Elemental Retreat: Yogi Divinity Fusioned with Mexican Indigenous Roots - (Hospitality added value tax of 10% - prices/person)
7 Day Music and Movement - Pilates and Functional Training Retreat - (Hospitality added value tax of 10% - prices/person)
10 Days of Ocean Flow Yoga and Mayan Jungle Excursions - (Hospitality added value tax of 10% - prices/person)
7 Day Fishing Retreat - (Hospitality added value tax of 10% - prices/person)
7 Day Ocean Flow Here and Now Yoga and Meditation Retreat - (Hospitality added value tax of 10% - prices/person)
7 Day Oceanfront Yoga Retreat with Day of the Dead Celebration - (Hospitality added value tax of 10% - prices/person)
5 Day Summer Yoga and Wellness Retreat with Cenote Excursion - (Hospitality added value tax of 10% - prices/person)
If you selected a retreat with more than one date, please specify here:
If you are traveling with someone else please list their name(s)
Travel information

Please provide this information if you would like assistance with arranging your airport transfers, if you do not have this information at this time, you can email it to us later.
Arrival date and time
Airline and Flight #
Departure date and time
Airline and Flight #
Health Information
Do you have any health conditions (asthma, heart conditions, etc)? (Type no if you do not).*
Are you taking medication that we should know about? (Type no if you do not).*
Do you have any Physical limitations or injuries that we should be aware of i.e. back conditions, knee/shoulder problems, recent surgery, etc.? (Type no if you do not).*
Do you have any dietary restrictions (vegetarian food allergies, etc.)? (Type no if you do not).*
Yoga Experience
How long have you practiced yoga?
How often do you currently practice? (i.e. times per week)
What type of Yoga do you practice?
(Lyengar, Ashtanga, Vinyasa Flow, Power, Hatha, Biknam, non specific. etc)
What are you looking forward to from the yoga sessions and the retreat experience in general?
How did you find out about Copal retreats?
(internet search, specific website, friend, referral, Instagram etc.)
What are the most important factors that made you decide to choose Copal Retreats for your retreat?
Additional Comments
Are you a returning customer?

YesNo
Have you paid your deposit ($350.00) already?*

YesNo
My Products
prevnext( X )
Retreat Depositnon-refundable deposit of $350.00 + 10% tax will be charged to reserve your room.
$350.00

Total

$0.00
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Signature

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Date

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Temazcal?

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Do you authorize Copal to upload photos of you to our stories and social media presence? :)*

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Terms & Conditions
If you have selected "no" for the field "Have you paid your deposit ($350.00) already?" above; kindly ignore the payment method below and proceed to submit the form :)
After submitting your form a non-refundable deposit of $350.00 + 10% tax will be charged to reserve your room.

Full payments due 90 days prior to the start day of the Yoga retreat.
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Yoga Retreat Waiver Form

Retreats

Travel information

Health Information

Yoga Experience

Terms & Conditions