Yoga & Meditation Stay-cation Weekend Retreat Registration

Yoga & Meditation Stay-cation Retreat Registration

May 19 - 21, 2017
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
I would like to receive occasional newsletter emails from Pilar Garza Yoga

Yes!No thanks
Phone Number

Area CodePhone Number
Injuries/Areas of Concern & Medications
Emergency Contact Information
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First NameLast Name
Phone Number*

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Meal Preference

5/15 deadline to accommodate specific dietary requests such as allergies, gluten free, etc.
Please select your preference*
Full Payment due upon registration. Private rooms are now sold out.*
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Shared Room - Pay in Full (includes $100 non-refundable deposit)$375.00

Subtotal $0.00Tax $0.00Total $0.00
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Yoga & Meditation Stay-cation Retreat Registration