Retreat Registration Form

Registration Form

Thank you for your interest and willingness to participate in the Re-Treat Yourself self care and personal development retreat being held at a private location in Monticello, GA March 17, 2024, from 8:08am until 4:04pm. This is a carefully curated holistic event that offers guided yoga meditation, touch therapy through collective bonding, group panel discussion w/special invited guests, a fire release party, giveaways and so much more…. Join us for this transformative experience as you RELAX, REFLECT, RESTORE, and RENEW!! Please fill out the registration form below so that we can get to know you better! Breakfast and Lunch will be provided….
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Email
example@example.com
Cell Number
Format: (000) 000-0000.
Emergency Information
Emergency Contact's Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Have you practiced Yoga before?
Are you interested in any add’l services or accommodation(s)? Please advise. (I.E. Private Masseuse, Foot Detox, lodging, transportation etc)
Do you have any health limitations or physical injuries? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma, diabetes, seizures, osteoporosis, etc.)
Are you bothered by scents (essential oils, incense, perfumes etc.)? If yes, please let us know the details.
Do you have any special dietary requirements? (eg: gluten-free (please specify if you are celiac), allergies, vegan etc…)
What inspired you to come to this retreat?
AGREEMENT OF MEDIA RELEASE AND WAIVER OF LIABILITY

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 selfcare and personal development related information and instruction. I recognize that all exercise programs may require physical exertion and I am fully aware of the risks and hazards.

If at any time during the activities I feel discomfort or pain, I will listen to my body and respect its limits at all times.

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

I understand the $222 energy exchange for the retreat is final with NO refunds. I agree that any and all cancellations,due to whatever reason, must be in writing(sent to- info.iamhairforyou@gmail.com) and made less than two weeks in advance of the retreat date 3/17/2024. Once submitted and received, it will and can be transferable to another person or service of the host, " I Am Hair For You Consulting LLC."

I understand that photos and/or videos taken will be shared, tagged, and used for promotional,educational etc purposes and I authorize/release to the host(s), instructors and hosting facility.

I have read the above media release and waiver of liability and fully understand it’s contents as well as the Refund/Cancellation Policies. I voluntarily agree to the terms and conditions stated above.
Signature
Date Signed

MonthDayYear
Date
Retreat Yourself

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USD$222 Energy Exchange
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Registration Form

Retreat Yourself