may 16th - 19th 2019

Yosemite Valley California

Registration Form

name *
cell phone # *
cell phone #
In Case of Emergency
emergency contact phone # *
emergency contact phone #
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
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
talk to us if this is an issue and if you need a payment plan etc.
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 yoga, 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