**Participants** - Texas Yoga Retreat

First Name *

Last Name *

Email Address *

Phone *

Billing Street Address *

Apartment, suite, etc

Billing City *

Billing State *

Billing ZIP Code *

(optional) If you would like your pronouns listed on your name badge, please enter them here.

Emergency Contact Name & Relation *

Emergency Contact Phone *

Will you be attending the full retreat (3 days) or do you need day passes? *Full RetreatDay Passes

Day Passes (you must select at least 2 days)Friday ($145)Saturday ($350)Sunday ($235)If only wanting 1 day pass, register through Retreat + Meals + Commute

Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Select One

Bath for Shared Room (for 2 Nights) *Private Bath (+$30)Common Bath (no added fee)

Bath for Private Room (for 2 Nights) *Common Bath (no added fee)

Bath for Private Room (for 2 Nights) *Private Bath (+$40)Common Bath (no added fee)

Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Private ($290)Select One

Bath for Shared Room (for 2 Nights) *Common Bath (no added fee)

2nd choice Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Private ($290)Select One

2nd Choice Bath for Shared Room (for 2 Nights) *Private Bath (+$30)Common Bath (no added fee)

2nd Choice Bath for Private Room (for 2 Nights) *Private Bath (+$40)Common Bath (no added fee)

If you have a preference for your roommate(s), please list their name(s) here. If not, enter NA. *

Will you be arriving after 8pm on Friday? *YesNo

What time will you be arriving? *

Are you STRICTLY gluten free? *YesNo

Are you STRICTLY vegan (zero dairy, eggs, etc)? *YesNo

Do you have any MEDICAL dietary restrictions or food allergies that we need to know about? *YesNo

Please list your MEDICAL dietary restrictions or food allergies. *

Are they LIFE THREATENING? *YesNo

How did you learn about Texas Yoga Retreat (TYR)? *

Who referred you? *

Discount Code

Check here if applicable (must select to get 10% discount)10% Discount

Check here if applicable (must select to get discount) GRP15OFF15% discount for groups of 4 or more

Check here if applicable (must select to get discount) staff2024100% Discount (Staff2024)

Check here if applicable (must select to get discount) Soraya *15% Soraya

Check here if applicable (must select to get discount) J.K.15% discount

Check here if applicable (must select to get ALUMNI discount)$75 Discount

Check here if applicable (must select to get BEAL discount)$328.50 Discount

Please list the name of each person in your group who will be attending using this discount code *

Retreat Registration Fee

Early Bird Registration Fee

Day Pass Registration Fee

Accommodations Fee

Meals (hidden)

Discount

Total ($)

How do you want to pay? *ZellePaypal/Credit Card