Summer Meditation Teacher Retreat & Meditation Teacher Training Program
Application & Liability Release

PLEASE COMPLETE THE FORM BELOW

Name *
Name
Address *
Address
RESERVATION POLICIES:
- $750 deposit due at time of booking. - 50% of room total is due April 1, 2018 - Final payment is due by July 1, 2018. - Deposits and payments made prior to July 1 are 100% refundable. After June 30, 2018, all deposits and payments are non-refundable and will be forfeited should you decide to cancel your reservation. (Credits may be transferred to a replacement attendee.)  - A credit card must be provided with your reservation. -- Payments will be charged to that account automatically on the payment due dates. - Deposits and payments made after June 30, 2018 become nonrefundable after 7 days.  - 
Cancellations must be in writing. - 
Payments can be made by cash, personal check from a U.S. bank account, or PayPal. - Credit Cards accepted for a 3% service charge. - Payments made in full by check in advance of the payment due dates may receive a $50 discount. - The Mindfulness Center reserves the right to cancel retreats up until 30 days prior if there is a concern with lack of reservations and if it elects to do so will refund deposit money. We regret that travel and flight payments made by attendees are non-reimbursable in the event of retreat cancellation.
I agree to and acknowledge the reservation policies. *
In participating in the programs and activities that are provided for me by The Mindfulness Center and Retreat Leaders I do hereby waive, release and discharge The Mindfulness Center and Retreat Leaders from any and all responsibilities or liability for injuries or damages, including negligence, resulting from my participation in any activities. I agree that by participating in the retreat activities I do so entirely at my own risk and volition. Furthermore, I hereby release The Mindfulness Center from liability for any injury or illness that I may incur, now or in the future as a result of participating in the activities offered to me. I understand that it is my choice to participate in as many or few of the retreat activates as I choose. *
I acknowledge that either (select one):
How many years of experience do you have with each of the following: * All levels welcome.
What type of Yoga do you prefer (you may select more than one): *
Please indicate your interest in the following (1: no interest / 10: high interest):
ROOM TYPE SELECTION: *
Are you planning to travel alone but interested in being paired with another person for room sharing?
This is not a guaranteed option.
Sign:
Date *
Date

Summer Meditation Teacher Retreat &      Meditation Teacher Training Program
Application & Liability Release Form

HISTORIC KENT MANOR INN, STEVENSVILLE, MARYLAND, JULY 11-15, 2018

and online meditation teacher training & Certification

PLEASE COMPLETE THE FORM BELOW