December 30th 2015 to January 3rd 2016

Joshua Tree California

Registration Form

name *
name
cell phone # *
cell phone #
In Case of Emergency
emergency contact phone # *
emergency contact phone #
Climbing, Yoga, & AcroYoga info
if you don't have one that is fine just let us know. Also anything you would like to learn in terms of climbing can be added here
if you don't have one that is fine just let us know. Also anything you would like to learn in terms of AcroYoga/ Yoga can be added here
Travel Plans
*meaning by car, train, plane, or horse and buggy!
*please list how many seats in your car you have for people **please take into account their camping gear
Rental Gear
*please check all that you need
*mark M for male and F for female. If you have never worn climbing shoes before or unsure, please put down your street shoe size and specify Street Shoe Size.
*Pant waist size. please mark M for male and F for female
Fun Stuff
Payment
talk to us if this is an issue and if you need a payment plan etc.
Deluxe Package: all meals included starting with breakfast on the 30th until lunch on the 3rd Economy package: meals included dinner on the 31st Breakfast on the 1st
RETREATER CONSENT AGREEMENT:
I agree that I am participating in an Yoga Squirrel Event, during which I will receive information and instruction about rock climbing, yoga, and AcroYoga. I recognize that both rock climbing and AcroYoga require physical exertion that may be strenuous and may cause physical injury; I am fully aware of and accept full personal responsibility for the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the rock climbing and yoga retreat. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the rock climbing and yoga retreat. In consideration of being permitted to participate in this climbing and yoga retreat, I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, past present or future, which I might incur as a result of participating in any climbing, hiking, yoga/AcroYoga practice, workshops and activities at the retreat. In further consideration of being permitted to participate in this climbing and yoga retreat, I knowingly, voluntarily and expressly waive any claim I may have against Yoga Squirrels, Casey Stroud, Sonia Peltzer and any of the staff, for any injury or death caused by their negligence or other acts. I have read the above release and waiver of liability and all terms and conditions and fully understand its contents. By checking the box below, I voluntarily agree to the terms and conditions stated above.
todays date *
todays date