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Date of Birth:
Cell Phone #:
Emergency Contact (Name & Number):
Name of Roommate:
1. Please describe your yoga experience (No experience is ok :)
2. Do you have any injuries, old or new? Please explain. Recent injuries will require a doctor’s note of approval.
3. What would you like to get out of this retreat?
4. Are there any specific areas of your body that you would like to work on improving strength or flexibility?
5. Are there any specific asanas (yoga postures) that you would like to go over?
6. Which room would you like to reserve for your stay? Please indicate if this will be a single, double, triple occupancy? Room #?
7. Do you have any allergies? Special Diet? Vegan? Gluten free? Not all locations can accommodate for every diet. Please lets me know about your dietary requirements in advance to see if the location you have chosen fits your needs.
8. Will you be celebrating any special occasions during your stay?
9. How did you hear about Namaste Yoga Retreats?
A Deposit is required to confirm reservation.
$100pp for 1+ night retreat
$500pp for 3+ night retreat
Cancel 100+ days prior to start of retreat 100% Refund, minus your non refundable deposit
Cancel less than 100 days- No Refund unless room can be filled. If room is filled, 100% Refund, minus your non refundable deposit
Travel insurance is required for all retreats. COVID can cause last minute cancellations for any trip. Please choose an insurance policy that includes last minute cancellation due to COVID or any other illness. You also want a policy that covers hotel quarantine in the case of a positive test during your stay. Travel insurance policies vary in coverage and can be purchased on an annual basis or for a single trip. Do your research and purchase one that covers all of your needs.
I understand that if my roommate cancels I have the option of cancelling according to the terms listed above or paying the single rate for the room I have booked. Please sign and date that you have read and understand the cancellation policy.
Space is limited. To reserve your spot today, please send your registration form and check to:
402 Moraine Street
Marshfield, MA 02050
Please make checks payable to "Namaste Yoga Retreat"
Venmo Accepted - @Patricia-Glynn-1
In the photo I am in a blue dress on the beach
Please contact me if you have any questions.