• Registration Form

    Registration Form

    Reconnect with Your Authentic, Higher Self and Allow Yourself Space to Receive
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Information

  • Format: (000) 000-0000.
  • Have you practiced Yoga before?
  • Gender*

  • AGREEMENT OF RELEASE AND WAIVER OF LIABILITY - CANCELLATION POLICY INCLUDED

    I hereby agree to the following:

    As I participate in activities offered by the hosts and special guests, I understand that the offerings of this retreat are not a substitute for medical attention, examination, diagnosis, or treatment. I will receive fitness/spiritual related information and instruction. I recognize that all exercise programs require physical exertion that may be strenuous and may cause physical injury and I am fully aware of the risks and hazards. I understand that any spiritual modalities offered are not in place of medical advice. The purpose of maintaining confidentiality within the group is to create a safe and trusting environment for open discussion and sharing.

    If at any time during the activities I feel discomfort or pain, I will inform and seek assistance from the teacher.

    I may rest at any time during the class and over the weekend. I will listen to my body and respect its limits on any given day.

    I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any activity program. I represent and warrant that I am physically fit and I have no medical condition that would prevent my participation in fitness classes or workshops.

    I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every class.

    I accept that neither the instructors, nor the hosting facility, are liable for any injury, or damages, to person or property, resulting from my participation in this retreat. 

    Exclusion of Participation: 

    In the unfortunate circumstance, if a guest conceals physical and/or health issues, is unfit, and/or causes disruptions that endanger the provision of the service and/or the health of other participants, facilitators, or equipment the guest can be excluded from the participation of the Retreat after an initial warning. If the situation arises, the contract will be terminated without further notice, already paid costs are non-refundable and incurring costs are to be paid by the guest.

    CANCELLATION POLICY:

    •  Cancellation requests made before June 1 will receive a full refund.

    •  No refunds will be issued for cancellations made after June 1. 

    Please note that all cancellations must be submitted in writing to dawn@bodyignite.com. Thank you for your understanding and cooperation.

  • CONFIRMATION

    By acknowledging and signing below, i am delivering an electronic signature that will have the same effect as an original manual paper signature. the electronic signature will be equally as binding as an original manual paper signature.

  • Date of Signature*
     - -

  • Retreat Packages

    Kindly select the retreat packages you wish to access during the 'Be Authentically YOU' Retreat.
  • Regular Pricing Returns After April 1st
  • Which add-ons would you like to include to enhance your retreat experience? Please select all that apply:

  • *Please remember that when you book Ayurvedic Treatments with Whitney, your payment covers her service fees directly. As for any cash (energetic exchange) donations made during the Llama Farm walk for Larry Fiske, it's a way of supporting his care for our llamas through an energetic exchange. Your contribution makes a difference and is greatly appreciated.

  • Payment Methods

    We only accept full payment via Zelle or Venmo. See below instructions.
  • Please choose your preferred payment method below.*
  • Image field 174
  • Image field 171
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Image field 173
  • Should be Empty: