Yoga Retreat Waiver Form
Name
*
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Male/Female
Male
Female
Age
Email
*
example@example.com
Primary Phone Number
*
-
Area Code
Phone Number
Cell
-
Area Code
Phone 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
Please Select
7 Day Epic Adventure Yoga and Cultural Retreat in Italia - June 26 - July 2, 2024
7 Day Epic Adventure Yoga and Cultural Retreat in Italia - July 3 - July 9th, 2024
7 Day Rhythmic Flow Yoga Retreat with Mayan Jungle and Beach Adventures - Sept 24-30, 2023
7 Day Rhythmic Flow Yoga Retreat with Mayan Jungle and Beach Adventures December 27 – January 2, 2024
7 Day Ocean-Front Detox: Introduction to Ayurveda plus Yoga - January 15 - 21 – 2024
Honoring the Light Within - February 16-24 2024
Connecting with the Nature of Mind and Body Through Yoga and Pranayama - April 19 - 25 - 2024
7 Day Ocean Flow Here and Now Yoga and Meditation Retreat - October 6-12 - 2023
7 Day Ocean Flow Here and Now Yoga and Meditation Retreat October 15 - 21st, 2023
10 Days of Ocean Flow Yoga and Mayan Jungle Excursions - Sept 12-21, 2023
10 Days of Ocean Flow Yoga and Mayan Jungle Excursions Dec 5-14, 2023
10 Days of Ocean Flow Yoga and Mayan Jungle Excursions - Jan 5-14. 2024
Ignite your Inner Light and Rejuvenate your Soul with Caribbean Bliss - May 9-15, 2024
7-Day Chakra Balancing & Renewing Retreat - August 2-8 - 2023
Connect to your Inner Wisdom with Therapeutic Yoga and Ancient Mayan Culture - February 9-15th 2024
8-day fishing retreat - November 6th-13th 2023
10 Day Ocean-Front Detox: Introduction to Ayurveda+Yoga, Mayan Jungle Adventures and Sound Healing - January 30 - February 8, 2024
10 Day Ocean-Front Detox: Introduction to Ayurveda+Yoga, Mayan Jungle Adventures and Sound Healing - March 9-18, 2024
10 Day Ocean-Front Detox: Introduction to Ayurveda+Yoga, Mayan Jungle Adventures and Sound Healing - April 27 - May 6, 2024
7 Day Epic Adventure Yoga and Cultural Retreat in Italia - (Hospitality added value tax of 10% - prices/person)
Please Select
Private Single Room (Double Beds) - $3600 USD
Private Double Room (Double Beds) $2800 USD per person
7 Day Rhythmic Flow Yoga Retreat with Mayan Jungle and Beach Adventures - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1800
Beachfront Double - $1900
Rooftop Double - $2000
Courtyard Single - $2600
Beahfront Single - $2800
Rooftop Single - $3000
7 Day Ocean-Front Detox: Introduction to Ayurveda plus Yoga - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Single - $2500
Beachfront Single- $2700
Rooftop Single- $2900
Courtyard Double- $1850/double
Beahfront Double- $1950/person
Rooftop Single - $2500
10 Day Ocean-Front Detox: Introduction to Ayurveda+Yoga, Mayan Jungle Adventures and Sound Healing - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Single - $2700
Beachfront Single- $2900
Rooftop Single- $3100
Courtyard Double- $1950/person
Beahfront Double- $2050/person
Rooftop Single - $2150
Honoring the Light Within - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Single - $2500
Beachfront Single- $2700
Rooftop Single- $2900
Courtyard Double- $1850/double
Beahfront Double- $1950/person
Rooftop Single - $2050/person
Connecting with the Nature of Mind and Body Through Yoga and Pranayama - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1800
Beachfront Double - $1900
Rooftop Double - $2000
Courtyard Single - $2600
Beahfront Single- $2800
Rooftop Single - $3000
7 Day Ocean Flow Here and Now Yoga and Meditation Retreat - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1800
Beachfront Double - $1900
Rooftop Double - $2000
Courtyard Single - $2600
Beahfront Single- $2800
Rooftop Single - $3000
7-Day Chakra Balancing & Renewing Retreat - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1800
Beachfront Double - $1900
Rooftop Double - $2000
Courtyard Single - $2600
Beahfront Single- $2800
Rooftop Single - $3000
Connect to your Inner Wisdom with Therapeutic Yoga and Ancient Mayan Culture- (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1800
Beachfront Double - $1900
Rooftop Double - $2000
Courtyard Single - $2600
Beahfront Single- $2800
Rooftop Single - $3000
10 Days of Ocean Flow Yoga and Mayan Jungle Excursions - (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1925
Beachfront Double - $2025
Rooftop Double - $3000
Courtyard Single - $2600
Beahfront Single- $2800
Rooftop Single - $2125
8day fishing retreat - (Hospitality added value tax of 10% - prices/person)
Please Select
$4000
Ignite your Inner Light and Rejuvenate your Soul with Caribbean Bliss- (Hospitality added value tax of 10% - prices/person)
Please Select
Courtyard Double - $1700
Beachfront Double - $1800
Rooftop Double - $1900
Courtyard Single - $2400
Beahfront Single- $2600
Rooftop Single - $2800
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?
Yes
No
Have you paid your deposit ($350.00) already?
*
Yes
No
Date
-
Month
-
Day
Year
Date
Temazcal?
Yes
No
Do you authorize Copal to upload photos of you to our stories and social media presence? :)
Yes
No
Terms & Conditions
Signature
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