Rego Form — Sonja Mapleston

Name

First Name

Last Name

Phone

(###)

###

####

Address

How did you hear about this retreat?

What is your creative superpower?

This could be ANYTHING from the practical (drawing, painting, storytelling) to the obscure: surprise us!

How would you describe your current health?

Great

Good

Fair

Poor

Any illness or injury that may impact your yoga practice?

How would you describe your current health?

Great

Good

Fair

Poor

Please list your dietary requireme

Great

Good

Fair

Poor

Preferred Date

YYYY

What is your budget?

Please let us know your dietary requirements.

Please describe in detail any other health or medical condition that you believe may be helpful for your teacher / workshop facilitator to know:

Are you on any current medication?

If yes to the above, please describe:

Please use this space to ask or voice any concerns relative to your participation in any yoga, meditation, art workshops and other workshops with the Retreat team.

Liability Waver

I agree to the following: 1. The information I have provided on this form is complete and accurate. 2. I understand that participating in a yoga class involves risk of injury; I agree to be solely responsible for any injuries sustained by me as a result of my participation in this workshop/retreat or any future workshops/retreats I take with Sonja Mapleston Retreats. I am fully aware of the risks involved. 3. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any workshops offered at Sonja Mapleston Retreats. I represent and warrant that I am physically fit and have no medical conditions that would prevent me from participation in any wellness workshops. I assume full responsibility for any injuries or damages, known or unknown, which I might incur because of participating in any wellness workshops. I knowingly, voluntarily, and expressly, waive any claim I may have against Sonja Mapleston Retreats for injuries or damages that I may sustain because of participating in their wellness workshop and retreats.

Text

Retreat Registration Form

I live, work and learn in Meanjin, on the land of the Turrbal and Yuggera peoples.
I recognise their continuing connection to land, waters & community & pay my respects to Elders past, present and emerging. I acknowledge sovereignty was never ceded.

Retreat Registration Form

I live, work and learn in Meanjin, on the land of the Turrbal and Yuggera peoples. I recognise their continuing connection to land, waters & community & pay my respects to Elders past, present and emerging. I acknowledge sovereignty was never ceded.

I live, work and learn in Meanjin, on the land of the Turrbal and Yuggera peoples.
I recognise their continuing connection to land, waters & community & pay my respects to Elders past, present and emerging. I acknowledge sovereignty was never ceded.