Name *

First Name

Last Name

Phone

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Room Selection *

Select your room preference (first come, first served) *Pricing does not reflect Early Bird Special. If you sign up by May 8th you will receive $100 off listed price here.

3 Bed Dorm Room $2650

5 Bed Dorm Room $2650

Private King $2950

Private Jungle Dome $3300

Addt'l Friend in Jungle Dome $2300

I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I assume full responsibility for any and all damages, which may incur through participation. Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in such a fitness program. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Johanna Bowen, Womxn in the Pines, Melanie Sassano, Mellijay Services , its owners, officers, employees, and instructors. I have read and fully understand and agree to the above terms of this Agreement and Release of Waiver of Liability. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law in Georgia. *

I agree

Cancellation Policy: If for any reason an attendee must cancel, you will receive: Full refund (- deposit) if cancelling ON / BEFORE June 25. Half refund (- deposit) if cancelling June 26 - July 25. No refund if cancelling July 26 - Aug 29. If for any reason Women InCorporated cancels the event, you will receive: Full refund. *

I agree to cancelation terms

I grant permission to Johanna Bowen, Womxn In The Pines, Melanie Sassano, Mellijay Services, and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Johanna Bowen, Womxn In The Pines, Melanie Sassano, Mellijay Services and its legal representatives for all claims and liability relating to said images or video. I waive my right to any compensation.

I have read and agree with the above statement

Today's Date *

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