Winter '24 Moksha Retreat Registration

MOKSHA RETREAT WINTER '24: REGISTRATION

Price includes program, materials, select meals, choice of single or double occupancy room.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Company
Title
Age Range
No restrictionsVegetarianVeganGluten-free
The Zen Within WebsiteThe Zen Within WorkshopReferralLinkedInYoutubeInstagramOther
Single Occupancy Room - I am attending Moksha aloneDouble Occupancy Room - I am attending Moksha with a friend
Name of the person you would like to share a room with:*
Both occupants must register for Moksha separately. By writing your roommate's name here, we will assign you a double occupancy room together.

Select your preferred room occupancy:*

Single Occupancy Room

One King or Two Queen Beds, as available

$2,350.00

Double Occupancy Room

Two Queen Beds

$1,850.00

Total

$0.00

Cancellation, Liability Release, and Waivers:
- I understand that my registration is non-refundable 60 days or less before the start date of the retreat.
- I understand that my registration is transferable to another retreat date, if space is available, as long as I make that request in writing (email) at least 60 days before the start date of the retreat.
- I understand that there may be photography and/or videography taking place during the retreat and our activities. By registering to attend a retreat, I am agreeing to the release of my likeness and image for The Zen Within, LLC for possible inclusion in future marketing materials.
- I understand there is inherent risk attending any events or retreats, at any time of the year. I understand and agree that The Zen Within, LLC, Kim Taylor, and any/all associates of The Zen Within, LLC are not responsible for any accidents, injuries, loss of property, or other unforeseen experiences that may occur while traveling to, participating in, or returning from the retreat. I accept full responsibility for all aspects of my retreat experience and indemnify The Zen Within, LLC, Kim Taylor, and any/all associates of The Zen Within, LLC from any and all responsibility or liability.
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