Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Emergency Contact Phone # *

Country

(###)

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Desired Accommodations: *

Double Occupancy Cabana

Triple Occupancy Cabana

Dorm Cabana (female only, shared bath)

Please read the International Retreat Terms and Conditions *

I understand that a non-refundable deposit of $500 is required to reserve my space.

I understand that 50% of the balance due must be paid no later than September 30, 2025.

I understand that the remaining balance is due no later than October 30, 2025.

I understand that if I cancel prior to September 30, 2025, all moneys paid beyond the $500 nonrefundable deposit will be refunded.

I understand that if I cancel after September 30, 2025, a refund of monies paid beyond the non-refundable deposit is only available if I can provide another participant to fill my space.

I understand that no refunds are given within 4 weeks of the start of the retreat.

My passport is valid for at least 6 months beyond the period of the retreat.

I have read and understand the terms and conditions for this retreat.

AltheaYoga Waiver of Liability

I affirm that I am in good health, and I alone am responsible to decide whether to practice yoga, given the physical and mental nature of the practices. I understand my physical limitations and I am sufficiently self-aware to stop or modify my participation in any Activity before I become injured or aggravate a pre-existing injury. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Althea Cervantes and her assistant teachers.

I consent to being photographed during this retreat for AltheaYoga marketing purposes.

I am making my payment via: *

Your reservation is confirmed when both this registration form and your deposit/payment has been received. I will confirm with you via email. Thank you!

personal check (mail to Althea Cervantes, 3250 Ben Lomond Drive, Sacramento, 95821)

Zelle - preferred (althea@altheayoga.com)

Venmo (@ALTHEA-CERVANTES)