Autumn Bliss: A Restorative Yoga Retreat Registration Step 1 of 5 20% Personal InformationName* First Last Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone* AccommodationsAll nine rooms in the retreat house have access to three shared hall bathrooms. Beds are twin-sized European-style platform beds with high quality mattresses. Linens, towels, meals, and all yoga sessions are included in the cost. Room Selection*Prices are per person. Private rooms are sold out.Share Room for 3 or 4 - $425Share Room for 2 - $525Preferred Roommate(s):List your preferred roommate(s) if applicable.Food Allergies/Preferences:Food at the retreat is vegan with dairy and eggs available on the side. Nearly everything is gluten-free, including the delicious baked goods. Please list any food allergies or sensitivities if applicable.Optional Massage*Optional massages can be scheduled throughout the weekend. You will be contacted after your registration is received to select appointment time.No MassageMassage - $75 Coupon Total $0.00 Payment Method and PolicyPayment is accepted by check or credit card via Paypal.Payment Method*CheckPayPal Cancellation PolicyShould you be unable to attend the retreat, your cancellation request must be received in writing via email to email@example.com by September 27, 2017 in order to receive a refund. Cancellation requests received after September 27, 2017 are eligible for a credit towards retreat in January 2018. All refunds and credits are subject to a $50 non-refundable administrative fee. Paid registrations are transferable to another individual at any time and are not subject to administrative fees.Cancellation Policy* Yes, I read and agree to this cancellation policy. Liability WaiverI am aware that some yoga activities scheduled for this weekend require physical exertion that may be strenuous, and participation in yoga may result in accident or injury. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the yoga classes, workshops, private sessions, or trainings offered by Tara Lemerise Yoga, Tara Lemerise, and Susan Timmons Marks. I assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in this retreat. By signing, I agree to release from all liability and to hold harmless Tara Lemerise, Tara Lemerise Yoga, Susan Timmons Marks, and Blue Mountain Retreat Center and its owners, officers, employees and agents from any claim, including but not limited to claims for property damage, personal injury, death or loss of any kind arising out of yoga classes, workshops, private sessions, or trainings. My heirs and legal representatives also forever release Tara Lemerise, Tara Lemerise Yoga, Susan Timmons Marks, and Blue Mountain Retreat Center from all liability. Liabilty Waiver* Yes, I read and agree to this liability waiver.