Retreat With Us!

We are so excited that you are interested in joining us on retreat!

We look forward to connecting with you soon!

Name

First Name

Last Name

Phone

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Retreat with us!

What retreat are you inquiring about?

How did you hear about this retreat?

What is your room preference?

single occupancy

double occupancy

triple occupancy (if applicable)

Why are you interested in joining this retreat and what are you looking to receive from this immersion experience?

How can we best support you while on retreat, so that you have the most amazing experience ever?

Do you have any dietary restrictions or allergies that we should let the kitchen know about?

Who is your emergency contact (name and # please)?

PLEASE SIGN THE BELOW BY TYPING YOUR NAME. BY TYPING YOUR NAME YOU ACKNOWLEDGE AND AGREE TO THE FOLLOWING: I am aware that Chelsea Winters LLC & Anahata Yoga CO and its teachers are here to serve me by sharing the knowledge of yoga and health. I recognize that yoga requires physical activity, which may at times be strenuous. By my participation in the classes at Anahata Yoga Co or any other retreat locations, I present to you that I am physically fit and agree to take full responsibility for not exceeding my limits in the practice of yoga and for any injury I might suffer in the practice of Yoga. It is my responsibility to ascertain that there is no medical reason to prevent my participation. If I am pregnant, I will disclose that to Chelsea Winters LLC & Anahata Yoga & Wellness and take full responsibility for my wellness. In consideration for Chelsea Winters LLC & Anahata Yoga CO and its teachers, I assume full risk for any injuries I may incur and waive any claim that I might have at any time for injury of any sort against Chelsea Winters LLC & Anahata Yoga CO and its teachers or any person or entity in anyway involved therewith. I assume full responsibility for any injuries or incidents that may occur during my practice at Anahata Yoga Co. or any location with Chelsea Winters LLC. I also acknowledge that if I am traveling in a foreign country, I am fully responsible for my own safety and security. I have fully read the above release and fully understand and agree to the above. By typing my name below I agree to all of the above.