REGISTRATION FORM: Seek the Sun 2017 Winter Yoga Retreat w/ Linda Meacci (Jan 21-28, 2017)
WHEN YOU HAVE COMPLETED THE registration form in its entirety and applied your e-signature in Section 8, you may print a copy for your records by following the instructions at the bottom of the form. . . . . When you are ready to submit the form, click the "SUBMIT" button at the bottom of the form.
* NOTE: Fields marked with an asterisk (*) are required.
Section 1: Participant Contact Information
Participant Name *
Participant Name
Participant Address *
Participant Address
Participant Phone *
Participant Phone
What type of phone is the above? *
Section 2: Emergency Contact Information
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone - Primary *
Emergency Contact Phone - Primary
What type of phone is the above? *
Emergency Contact Phone - Alternate (optional)
Emergency Contact Phone - Alternate (optional)
What type of phone is the above?
Section 3: Yoga Experience and Injuries
Briefly describe your yoga experience, including your level, how long you have been practicing, the primary style(s) of yoga you practice, and the frequency of your current practice (i.e., how many times per week or per month).
Briefly describe any injuries or concerns you may have relative to practicing yoga. **NOTE: Please review/update this information in person with the instructor at the start of the retreat.
Section 4: Lodging Preference
What type of room would you like? Select one. [Prices are per person.] *
For Double Occupancy, please select one of the following.
Section 5: Special Dietary Needs
What special dietary needs do you have? *
NOTE: The cooks will do their best to address special dietary needs; however, they may not be able to fully address all needs in all cases. Each villa has a fully equipped kitchen, and you are welcome to prepare your own snacks or to have some of your own food on hand to supplement the meals to ensure your individual needs are met.
Section 6: Payment
To reserve your space in this retreat, you must complete and submit the online registration form AND submit payment. If you register BEFORE December 15, 2016, a minimum $500 deposit must be paid at the time of registration (or you may pay the full retreat fee if you wish), with the BALANCE DUE by December 15, 2016. ON OR AFTER December 15, 2016, the full retreat fee must be paid at the time of registration. Please select a payment option: *
TO PAY BY CHECK -- Please make your check payable to LINDA MEACCI YOGA INSTRUCTION and mail it to Linda Meacci Yoga, 646 Maryland Ave, Pittsburgh, PA 15232 USA. [We will also email these instructions.]
Section 7: Terms and Conditions
Note: You must click the "I have read and agree" box after each paragraph.
RETREAT REGISTRATION AND PAYMENT: To reserve your space in this retreat, you must complete and submit the online registration form AND submit payment, per the instructions in Section 6. Your space is not guaranteed until your deposit (if registering before December 15) or full payment (if registering on or after December 15) is received. *
CANCELLATION POLICY: A CANCELLATION FEE of $250 applies to ALL cancellations. If you wish to cancel your registration, you must notify Linda Meacci Yoga Instruction BY EMAIL at If you cancel ON OR BEFORE November 30, 2016, your payment(s) will be refunded, less the CANCELLATION FEE. If you cancel AFTER November 30, 2016, your payment(s) will be refunded, less the CANCELLATION FEE, ONLY IF your spot can be filled from a wait list. NOTE -- Linda cannot be held responsible for weather, travel issues, or other circumstances beyond her control. When you book your airline ticket, you may want to consider purchasing trip cancellation insurance. *
WAIVER OF LIABILITY: You, the participant, assume all responsibility of risk, injury, and personal discomfort by registering for this retreat. It is your responsibility to inform the instructor immediately before, during, and/or after any yoga session or other activity of any pain, discomfort, and/or existing medical situations. With your signature, you release all instructors and facilitators participating in this retreat from any and all liabilities that result from your participation in any activities, classes, or lessons associated with this retreat. *
PARTICIPANT ELECTRONIC SIGNATURE (REQUIRED): You must check the box and type your full name in the space below. By doing so, you certify that the information you have provided on this registration form is truthful and accurate to the best of your knowledge and that you have read and agree to the Terms and Conditions outlined above. *
If you would like to print a copy of your completed form for your records, press the keystroke combination "CTRL-P" (press "CTRL" and "P" simultaneously) to bring up your computer's print menu. . . . . Or, right-click with your mouse and select "Print" or "Print preview" in the pop-up box. . . . . When you are ready to submit your registration form, click the "SUBMIT" button below.
NOTE: Once you click "SUBMIT," you will no longer be able to print your form.