Yoga Off Broadway

   (970) 328-YOGA

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Third Chakra Yoga Retreats

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First Name

Last Name

Email Address

Phone/Mobile

Mailing Address

Which dates will you attend?

Cost of Trip *See Details

Roomate Name

Tell us about your yoga practice

What is your main goal for this retreat?

I have read and agree to the cancellation policy

*CANCELLATION POLICY: Upon submitting this form, you will need to pay a non-refundable deposit of $500 per person to secure your spot.  This deposit is transferable but not refundable.  If the deposit is received BEFORE December 15th, 2011 the cost of a single occupancy in a tented room with one cot is $1375.  If the deposit is received on or after December 15th, 2011 the single occupancy rate is $1550.  Double Occupancy in a tented room with two cots is $ 1031 per person if $500 deposit is received before 12/15/11.  If you are signing up for double occupancy and the deposit is received after 12/15/11, the rate is $1162 per person.  Please send check to: Yoga off Broadway PO BOX 5938, Eagle CO 81631.  Checks made out to Yoga off Broadway.  Full payment is due January 15, 2012.  We can take credit card payment. Please call 781-405-4559 for more details

FILL OUT THIS FORM TO REGISTER FOR THE BAJA YOGA RETREAT IN FEBRUARY 2012