Radiant Wellness Retreat Registration Form

Registration Form
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Dietary Restrictions (at this time we are only able to accommodate vegan, vegetarian, and gluten free options)
Do you have any health or mobility concerns we should be aware of?
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How would you rate your level of experience practicing yoga?
What is one thing you are most looking forward to about this retreat?
Any other thoughts or questions you'd like to share with us?
By signing below and completing your registration, you are agreeing to the stated policies in our Agreement as listed below. A $700 deposit is required to secure your room selection. The remaining portion of your registration fee will be due no later than 8/20/2024. Cancellation Policy: If you wish to cancel your retreat attendance, you must notify Root Down to Rise in writing by contacting michelle@rootdowntorise.com. A full refund of any payments made is available until 7/20/2024. A 50% refund of all payments made will be available until 8/20/2024. No refunds will be available after 8/20/2024. Exceptions to our cancellation policy cannot be made for ANY reason. There is no refund for arriving late or leaving the trip early. Retreat Pricing: All prices are per person and are set well in advance of the retreat start date. Prices include retreat costs only; they do not include airfare or transportation to and from the retreat. All prices are set and are non-negotiable.Retreat Changes and Cancellations: Root Down to Rise reserves the right to make any changes deemed necessary; including, but not limited to: staffing assignments, advertised excursions, arranged transportation, advertised meals, etc. In the rare case of a Root Down to Rise retreat cancellation, Root Down to Rise will offer a full refund of your payments made to Root Down to Rise. Root Down to Rise is not responsible for any expenses or damages incurred as a result of a retreat cancellation including preparation costs, airline tickets, travel documents or other expenses. Root Down to Rise reserves the right to cancel any retreat prior to departure in the event that there are too few people booked, in which case you will be given a full refund of any and all payments made to Root Down to Rise. You will not be entitled to claim any additional amounts or seek any compensation for any injury, loss, expenses or damages (either direct or consequential) or for any loss of time or inconvenience which may result from such cancellation (including but not limited to visa, passport and vaccination charges, or departure, gear purchases, airport and airline taxes).Permission for Capture and Use: Media is defined as photography, video, written or verbal testimonial, or any other form of capturing likeness. For valuable consideration received, I grant to Root Down to Rise the absolute and irrevocable right and unrestricted permission concerning any captured media that she/he has taken or may take of me or in which I may be included with others, to use, reuse, publish, and republish in whole or in part, individually or in connection with other material, in any and all publishing platforms now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, editorial, advertising, and trade, without restriction as to alteration; and to use my name in connection with any use if she/he/they so chooses.Safety: By signing below, I acknowledge that participation in yoga classes or other activities during any part of this retreat exposes me to a possible risk of personal injury. I understand that I am responsible for judging my own physical limitations and capabilities, and that it is my responsibility to determine that there is no medical or other reason to prevent, impact or limit my practice of yoga or any other activity at this retreat. I agree that I will not exceed my physical capabilities and limitations while practicing yoga or engaging in other activities at this retreat. I am fully informed and aware of the risks inherent in the practice of yoga and I, alone, am responsible for deciding to practice yoga or participate in other activities. I hereby IRREVOCABLY WAIVE, RELEASE, ACQUIT AND FOREVER DISCHARGE Root Down to Rise and its owners, employees, volunteers and instructors from any and all claims or causes of action of any kind, known or unknown, now existing or that might arise hereafter, including, but not limited to, any and all claims for negligence or for any personal injury, or any other claims arising from, or in any way connected with, my participation in yoga, activities, or any event sponsored by Root Down to Rise.
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