First & Last Name
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Email
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Phone
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(###)
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact First & Last Name
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Emergency Contact Phone
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(###)
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Do you have any injuries/conditions that we should know about?
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Do you have any allergies we should know about?
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Do you have any dietary restrictions?
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What is your SECOND choice for room accommodations?
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Casita Standard
Are you traveling with another retreat participant, and would you like to room together?
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If yes, please provide their name below and we’ll do our best to accommodate your request.
Assumption of Risk & Health Warranty
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Yoga is an individual experience, and I understand that I should progress at my own pace while participating in the physically active portions of any Eclipse Power Yoga Retreat. If at any point I feel injury, overexertion, or fatigue, I will respect my own body's limitations and rest before continuing Yoga or any other exercise. I will take care of my body and do my best to remain healthy.
I acknowledge that participation in any Eclipse Power Yoga Retreat naturally involves the possibility and risk of injury to me. I further acknowledge that specific risks include injuries resulting from over-exertion, physical adjustment, improper or negligent use of equipment, failure to follow instructor instructions, or injuries resulting from participation in an inappropriate level of physical exercise. As such, I understand and voluntarily accept these risks.
I represent that I am in good health, at least 18 years of age, have the necessary current medical approval to engage in physical exercise, yoga classes, and retreats, and have no disability, impairment, injury, disease, or ailment that would cause risk of injury or adverse health consequences as a result of engaging in physical exercise and yoga classes during the retreat. I acknowledge that the facility where I am attending the retreat and Eclipse Power Yoga are relying on this representation and understand that neither the facility nor Eclipse Power Yoga will investigate or certify my health or fitness to participate in physical exercise and yoga classes during the retreat.
Release & Waiver of Liability
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I agree to take classes/workshops/virtual classes/retreats at Eclipse Power Yoga and I accept full responsibility for performing only those movements and activities that support and do not jeopardize my health and well-being by participating in these classes.
I understand that fitness classes and workshops carry a risk of injury as does all physical activity and sign this waiver of liability in agreement that I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in any programs.
In further consideration of being permitted to participate in the fitness Class/Workshop/or other events, I knowingly, voluntarily and expressly waive any claim I may have for Eclipse Power Yoga and its affiliated instructors for any injury or damages that I may sustain as a result of participating in the program. I understand that upon entering any public building, there are risks, and I will not hold Eclipse Power Yoga liable for any harm or injury obtained to me in or around the perimeters by any type of scenario within or outside the class I am attending.
I understand that Eclipse Power Yoga is a public facility in which airborne viruses may be present. I agree that I will not hold Eclipse Power Yoga liable for any illness which may be contracted by visiting a public facility and being in proximity with others, and for any allergic reactions to airborne remnants of cleaner within the studio. I understand that both Eclipse Power Yoga and its affiliated instructors are not diagnosing, prescribing or treating. I agree to consult a doctor or medical professional about a state of pathology, dysfunction, or pain, and to advise my instructors about such concerns. I understand that prior to beginning any exercise routine; I should consult with a medical professional. I also understand I am responsible for the security of my belongings and should keep any valuables with me at all times or should not bring them into the studio. I, my heirs and/or legal representatives, forever release, waive and discharge eclipse power yoga, and its representatives or agents, from any and all claims whatsoever, whether in tort, theft, negligence, intentional, reckless and/or any other claim whether known or unknown.
Payment Policy
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Payment Policy:
A $600 deposit is required to hold your spot.
Pay in full by October 2nd, 2025 and receive a $120 Spa Credit.
Payment Plan:
Payment #1 (or full payment) is due October 2nd, 2025.
Payment #2 is due December 2nd, 2025,
Payment #3 (final balance) is due February 2nd, 2026.
Payments can be made via cash, check, or credit card. A 3.5% credit card processing fee will be added as a separate line item on all card payments.
Cancellation Policy
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120 days prior to retreat:
Full refund less $600 non-refundable deposit
90 days prior to retreat:
50% refund less $600 non-refundable deposit
Less than 60 days prior to retreat:
No refund. If paid in full, a credit in the amount of your tuition, not including the $600 non-refundable deposit, will be applied to your account.
