Registration Form

Name:


Address:

 
Phone #:

 
Cell Phone #:

 
Email:

 
Emergency Contact (Name & Number):



​Retreat Location:


 
Name of Roommate:

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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. 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

Cancellation Policy
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

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



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Signature                                                                                               Date
 


Space is limited.  To reserve your spot today, please send your registration form and check to:


Tricia Glynn
402 Moraine Street
Marshfield, MA 02050
USA

Please make checks payable to "Tricia Glynn"
 
Venmo Accepted

Please contact me if you have any questions. 

 

Tricia Glynn

namasteyoga77@yahoo.com

617-947-2983
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