Soulflower’s Retreat Registration Thank you so much for your interest in Soulflower Retreats!Please fill out and submit this form to register for one of our retreats. Once we receive your registration, we will reach out with the next step of securing your spot. Name as it appears on your passport * First Name Last Name Phone * (###) ### #### Email * What retreat are you signing up for? * Africa Dominican Republic Utah How did you hear about this retreat? * What inspired you to sign up for this retreat? * Do you have an dietary restrictions or allergies? * What is your birth date? * Include the date, time & place ;) This can be found on your birth certificate. Health Information: Do you have any medical conditions that might affect your full participation in physical activities? * Are you booking a private or shared room? * Payment: Will you be paying in full or with the payment plan? * Is there anything else you would like to share? By typing your name below, you are signing and agree to the following: * I attest that all of this information is current and accurate. If any changes should occur, it is my responsibility to inform the host as soon as possible. Should there be any changes to my travel plans, that is also my responsibility. I will communicate any changes with the host promptly. I am voluntarily participating in this activity. I understand that there as risks associated with my participation in this activity, such as physical and/or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, death or economic loss. Soulflower Refund Policy: All retreat payments are final and non-refundable. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. Thank you! We will review your form and reach out with your acceptance and invoice.Peace & Love,Sam, Alexis, and Kayla
