Retreat Application

Sign me up!!!

Name(required)

Email(required)

Phone Number(required)

Date of Birth(required)

Instagram / Social Media Links

Roommate Request

Do you have any food allergies? If so, what?

Shirt Size?

How did you hear about the retreat?

Emergency Contact(s)

Tell us about yourself!

What do you hope to get out of the retreat?

Is there anything you are nervous about going into the retreat?

How long have you been practicing yoga and/or free diving?

Do you have any injuries or illnesses we should be aware of? Are you on any medications we should be aware of?

List the places where you have traveled to. You can list just the ones that had a clear effect on you, or all of them. In each place, what changed in you as a result of your visit? What did visiting each place teach you?

List five of your most dominant interests.

By Applying you are agreeing to our TERMS AND CONDITIONS.

DISCLAIMERS

Accommodations are in shared rooms with shared beds
We’ll make every attempt to accommodate roommate requests. If you do not request a roommate we’ll choose one for you.
$500 deposit in non-refundable
Payment plans are available and not to exceed 4 equal payments
Cancellation requests need to be made in writing 60 days prior to the retreat date. Payments will be refunded with exception of a $300 administration fee and the non-refundable deposit.
Payment must be made in full by December 1, 2022
Akhila RVA is not responsible for
- Lost/Stolen Items
- Transportation issues (airline cancellations, missed flights, transportation issues, etc)
- Passport, Visa, Vaccine requirements
- Covid related instances, cancellations and/or restrictions
A signed waiver must be received with your deposit
Check Passport, Visa, Insurance requirements if you are entering from outside of the country
Check COVID and other medical requirements for the country of entry and origin. These are subject to change at any time.
SUBSTANCE ABUSE WILL NOT BE TOLERATED