Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Home Address
*
Preferred Pronouns
*
Date of Birth
*
MM
DD
YYYY
Can you be around aromatherapy?
*
Experience Options
*
Please list your roommate preference. If none is given, we will pair you with a new friend!
How are you intending to get to Vermont (e.g. drive, fly, train)?
Are you interested in carpooling or splitting a taxi to/from the airport to Sterling Forest Lodge? We can connect you with other attendees to arrange group transportation.
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone
*
(###)
###
####
Emergency Contact Email
*
Relationship
*
Do you have any medical conditions for us to be aware of? If so, please list.
Please describe any dietary restrictions or allergies.
What is your level of yoga experience?
*
How many years have you been practicing yoga?
*
Have you been on a yoga retreat before?
*
What draws you to your mat?
*
Please list the reasons you have chosen to come on this retreat. Please also include your aims and intentions. What do you wish to achieve while you are here?
*
Signed (Full Name and Date)
