Wilderness Yoga Retreat 2018 : Registration Form



Full Name: ____________________         Preferred Name: ____________________



1. Please select your preference for accommodation (circle)


  1. Tipi (fits up to 10)

  2. Forest House (hector health centre) Bunk beds

*if you are registering with a group of friends, please clearly indicate their names below so we can put you in the same tipi/room. Groups of 4 or more can be given their own tipi or room in the forest house. Groups of less than 4 will likely be paired with other participants, with a maximum of 6 people per room/tipi, unless a large group is requested.



2. Please select your choice of activity for Saturday afternoon(circle)



a- Lake canoeing (instructor led)

b- Giant “team” swing at high ropes course

c- I would prefer to not sign up for an activity Saturday


3. Investment & Payment option (please circle or indicate)


Early Bird

Tipi      $350.00+gst ($367.50)

Cabin    $430.00+gst ($451.50)



Tipi      $390.00+gst ($409.50)

Cabin    $470.00+gst ($493.50)

*Payment must be made in full by March 5th for early bird pricing. 50% non-refundable deposit required to secure your spot.


4. Previous Yoga Experience:




5. Any injuries or illness, past or current?




6. Do you have any allergies or food restrictions (vegetarian, gluten free, vegan, etc)? The kitchen is great at accommodating any dietary concerns.




7. What would you like to get out of this weekend?







8.Anything else you would like to tell us about?