Yoga in Costa Rica Retreat Registration Step 1 of 3 33% Personal InformationName* First Last Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Food Allergies/Preferences:*Three daily meals are served at the Lodge restaurant. Everything is prepared fresh each day, often straight from the onsite organic garden and meals feature inventive local cuisine and exotic native dishes, homemade breads, organic fruits and veggies, and scrumptious salads. Please list any specific food allergies, sensitivities, and dietary preferences. (For example vegan, vegetarian, pescetarian, gluten-free, nut allergy, etc.) Liability WaiverI am aware that some yoga and other activities scheduled for this retreat require physical exertion that may be strenuous, and participation in these activities 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/or Luna Lodge. 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, Luna Lodge 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 and Luna Lodge from all liability. Liability Waiver* Yes, I read and agree to this liability waiver. AccommodationsAll prices are per person. Review the list of inclusions/exclusions here: https://taralemeriseyoga.com/costa-rica-retreat/Room Selection*HaciendaPay in Full or Pay Monthly Installments*In FullMonthly InstallmentsHacienda (Pay in Full)*Fully enclosed hotel-style room close to the main lodge at the bottom of the mountain with private bathroom including shower and bathtub. (3 rooms remaining)Single Room - 1 Double Bed - $2,795Shared Room for 2 - 1 Double Bed & 1 Single Bed - $2,060Hacienda (Monthly Installments)*Fully enclosed hotel-style room close to the main lodge at the bottom of the mountain with private bathroom including shower and bathtub. (3 rooms remaining)Single Room - 1 Double Bed - 6 monthly payments - $465.83Shared Room for 2 - 1 Double Bed & 1 Single Bed - 6 monthly installments - $343.33Preferred Roommate:List your preferred roommate if applicable. If you select a shared room and do not indicate a roommate, one will be assigned to you.Total $0.00 Payment Method and PolicyPayment is accepted by check or credit card via Paypal. If you chose to pay deposit only, you will be invoiced monthly for future payments. Total due must be paid by March 1, 2020.Payment Method*CheckPayPalCancellation PolicyShould you be unable to attend the retreat, your cancellation request must be received in writing via email to email@example.com by February 29, 2020 in order to receive a refund. All refunds are subject to a $350 non-refundable administrative fee. There are no refunds available after March 1, 2020. Paid registrations are transferrable to another individual at any time and are not subject to administrative fees. Purchasing travel insurance is recommended. Travel insurance companies like TRAVEL GUARD offer policies that insure your investment in case you need to cancel (including “cancel for any reason” coverages), coverages for expenses incurred due to to weather & travel delays, personal property loss and emergency travel medical. Please review policies carefully to choose the coverage you need.Cancellation Policy* Yes, I read and agree to this cancellation policy.