2022 Harmonize Retreat

Embodied Flow™ 300h Yoga & Somatics Training Application

Welcome!

We are thrilled you have chosen to study with us.

The questions we ask are so that we can get to know you and make sure that the program is a good fit. We work with each of our students very closely in the classroom and in person. As we enter this journey together, this application is our first window into getting to know more about you and how we can best assist your personal growth. Please feel free to add or adapt answers to include what you would most like us to know about you.

I'm applying for (check all relevant)*

Body Module - in person, January 11 - 24, 2026 The Yoga Barn, UbudMind Module - in person, January 26- February 4, 2026 The Yoga Barn, UbudBody Module - in person, May 17-30, 2026, The Yoga Barn, UbudMind Module - in person, June 1-10, 2026, The Yoga Barn, Ubud

I understand that I need to meet the required prerequisites listed on the module page to join my selected modules*

yes

First Name*

Last Name*

Preferred Pronouns*

she/her, he/him/ they/them or any other combination you prefer

Email*

Street Address*

City*

ZIP / Postal*

Country*

Birthday*

Date

Phone Number*

Occupation*

Where did you first hear about this training?*

If from a friend, teacher or other, please specify

Who is your emergency contact?*

Emergency Contact Relationship*

Emergency Contact Phone Number*

please enter with country code!

Please upload a photo of yourself*

Have you attended a training, workshop or retreat with us before? If so, please tell us when and where.*

If you are a new student, where did you first hear about EMBODIED FLOW ™*

If you answered referral or other above, please specify and include full name of your referral*

Please tell us about your previous teacher trainings*

Do you have any other movement experience? (eg. dance, martial arts, capoeira)*

How many years have you been practicing yoga?*

How many years have you been teaching yoga?*

What brought you to this particular Advanced RYT-300 training*

Write about a time in your education when your comfort zone was challenged. What tools did you learn to help support that process in the future?*

If you are already a teacher, what do you consider your greatest strengths as a teacher/ facilitator?*

What areas of teaching do you wish to improve?*

What are three things that you think are unique about you, it could be an accomplishment, an injury, a special talent, something that nobody knows, things that when you think about yourself, make you "you"?*

How do you see yoga as an avenue of discovery? *

Anything else you would like to share about yourself ahead of the training? *

Please choose between vegan and vegetarian meals*

vegetarianvegan

Any food allergies we should know about?*

Are you proficient in English, both written and oral?*

yesno

PERSONAL WELLBEING & MEDICAL DETAILS

Choosing to be part of this training means that you are willing to go deeply into your own process and expansion. It is not intended as psychotherapy, however, it is designed to be challenging and transformative, and we provide support for this. Due to the nature of of the somatic practices we offer in Embodied Flow, sometimes traumatic memories and experiences may surface, which may be triggering or uncomfortable for some participants at some points. We will also be exploring tools for wellbeing, restoration and personal discovery. However please note that this is intended as a training program and not a program for the personal healing of trauma. Whilst the training will certainly provide tools and the opportunity for deep personal transformation and wellbeing, it also requires a level of resiliency and self-responsibility. We do our best to create a safe learning space for trauma survivors, and to educate all participants on trauma-sensitive language and practices. For your own and the group's best interest, we ask you to share openly and honestly about your personal experiences, wellbeing and medical details. Anything you share will remain confidential.

Do you have any current or recurring medical or physical condition that may affect your participation in this training? If so, please indicate the condition thoroughly below*

Are you currently in the care of a medical or natural health care practitioner? If yes, please describe:*

Do you have any other current physical, mental or emotional challenges that could possibly be an issue during the course? (It is important that we are fully informed of such challenges prior to the training). Please be thorough & list in detail.*

Please list previous injuries or surgeries & medical history*

Please list any previous mental health history, including treatment/medication for conditions such as depression, anxiety, panic attacks etc. including any hospitalizations*

Do you have a personal history of trauma experience? (You are not required to provide details here unless you wish to.) What approaches have you taken to work through it, and what is your current relationship to it?*

Anything else you would like to share about yourself before the training?*

REFUND POLICY:

It is the responsibility of each participant to book their flights and to find out about flight schedule changes and Covid-19 regulations relevant for this trip.

Travel Insurance is strongly recommended.

Cancellation refund requests for in-person & hybrid offerings

Cancellation 90+ days - 100% of the rate (minus deposit) will be refunded or 100% credit voucher towards a future event within 24 months of your initial event start date
Cancellation 60+ days: 50% of the rate (minus deposit) will be refunded or 100% credit voucher towards a future event within 24 months of your initial event start date
Cancellation within 30+: 25% of the rate (minus deposit) will be refunded or 50% credit voucher towards a future event within 24 months of your initial event start date
Cancellation less than 30 days prior to event start: no refund

Credit Vouchers are non-transferable and valid towards a future event within 24 months of your initial event start date

Credit vouchers can only be used for our 200h & 300h Training Modules and Immersions hosted directly by Embodied Flow™ & Tara Judelle LLC

EVENT CANCELATION:

In the unlikely event that the program is canceled, full payments will be refunded.

Travel expenditures will not be reimbursed, and are considered each individual's own liability.

Travel Insurance is strongly recommended.

Liability Waiver:

Embodied Flow™ & Tara Judelle LLC offer a variety of yoga retreats and trainings internationally. Some of the programs on this training require physical exertion, which may be strenuous and may cause physical injury. We recommend that you consult your physician before beginning any program. Students must listen to their own bodies and work within their own limitations. If any movements hurt or are uncomfortable; it is your responsibility to never take any exercise to a level of discomfort or pain.
Notice is hereby given that all arrangements made on behalf of participants are made by the organizers on the sole condition that the organizers shall not be held responsible for any injury, death, accident, illness, delay, loss, damage, act of negligence, or irregularity.

Embodied Flow™ & Tara Judelle LLC acts only in capacity as agent for the participant in all matters connected with hotel accommodations, sight-seeing tours, transportation and other travel expenses, whether by air, rail, bus, motorcar, boat or any other means and as agent holds itself free of responsibility for any damage occasioned by any cause. The undersigned hereby also agrees to indemnify and hold harmless Embodied Flow™ & Tara Judelle LLC or any other instructors or facilitators, from and against liability, damages, costs, loss or expense (including without limitation, attorney’s fees) arising out of any bodily injury, illness, or loss at any time sustained by the undersigned.

Talent Release:

I hereby give permission in perpetuity and without fee to Embodied Flow™ & Tara Judelle LLC, to use photography and video footage including copies thereof in which I appear in picture and sound, worldwide in any media or format for Tara Judelle & Embodied Flow™ trainings, advertising, and related promotional purposes. I acknowledge that Embodied Flow™ & Tara Judelle LLC owns all rights to the footage and any copies or format thereof and my participation confers upon me no rights of use, ownership or copyright. I appear voluntarily and there is no existing restriction or obligation that would prevent me from appearing. I release Embodied Flow™ & Tara Judelle LLC and their employees, agents, and assigns from all liability for any claims by me or any third party in connection with my participation.

MAKE-UP POLICY
For every four hours of class time missed, you will be required to make up the material with one private session. Material will be made up privately with a certified teacher at an additional cost. It is the students’ responsibility to keep up with their attendance requirements and to make up missed sessions. If you miss more than 20 percent of the course you will need to repeat parts or take an equivalency for an additional cost in order to receive your certification.

Choose your preferred payment*

$2250 USD Standard Rate: $500 USD deposit due within 7 days of acceptance of my application. Full rate due by November 1st, 2025$2400 USD Payment Plan: 6 monthly installments of $400 USD starting within 7 days of acceptance of my application.

I understand that*

for every 4 hours missed, I will need to make up with a 1 hour private session at additional cost to receive my certificate and that missing more than 20% of the training may result in loss of certification

I understand that*

all online live classes count towards certification and are mandatory

I have read & agree to the above Cancellation Policy, Liability Waiver, Talent Release and Makeup Policy*

yes

Please Sign*