Online registration and payments

    Your Personal Information
    1. Your Name
    2. Street Address
    3. City
    4. State
    5. Phone #s: Cell
    6. Email Address
    7. Occupation
    8. Date of Birth
    9. Your Gender MaleFemale
    10. I would like to be contacted via phone callI would like to be contacted via emailI would like to be contacted via phone and email
    Retreat Information
    1. Your Retreat Date
    2. Choose your retreat 7 STEPS TO BLISS Exclusive Self-Empowerment Immersion in Ubud, BaliDivine Body Detox & Yoga Retreat in Bali, IndonesiaChristmas Bliss Signature Yoga & Wellness Retreat in Bali, IndonesiaParadise Immersion Yoga & Wellness Retreat in Zanzibar, Tanzania
    3. Comments or Requests
    Emergency Contacts
    1. Name
    2. Relationship
    3. Email
    4. Phone #
    How did you hear about this retreat?
    1. Referral Yoga TeacherStudioFriend
    2. Internet FacebookTwitterGoogleOther
    3. Advertising FlyerBusiness CardOther
    4. Other
    Cancellation Policy


    In the event of your cancellation

    ∙ 50% deposit is not refundable
    ∙ Cancellations 30+ days prior to retreat: 50% non refundable, 50% refundable within a month.
    ∙ Cancellations 15+ days prior to retreat: 50% non - refundable, 50% non-refundable, but transferable to another retreat date within a year.
    ∙ No refunds for cancellations 0-15 days prior to retreat start date.

    In the event of cancellation by Bliss Body Retreat

    ∙ In the event of cancellation by Bliss Body Retreat, you will be refunded your entire payment
    ∙ Please confirm that the retreat has reached minimum capacity before purchasing your airline tickets, if required.
    ∙ Finalization/cancellation of retreat may occur up to 15 days prior to retreat.


    I agree that I am solely responsible for my own health and safety at all times during the Journey with Bliss Body Retreat. Neither the facilitators nor Bliss Body retreat team, their employees, nor any of Bliss Body Retreat's guest teachers or assistants, shall be held liable for any injury related to this Retreat. I agree to assume all risks associated with the program in any and all way. Furthermore, I also agree to inform the appropriate person(s) of any movements, activities that I feel may injure me and I will not perform any activity or movement, or engage in any treatment which I feel is likely to cause me to injure myself. I will inform the teachers, therapists, practitioners and/or assistants of any limitations or medical conditions that may affect my practice.I agree to treat my body with patience, compassion and respect during my practice.
    I understand I can stop and rest anytime. My signature indicates that I release Bliss Body Retreat team, their assistants, guest teachers, the place of the retreat, and their employees from all liability for any injuries sustained as a result of my participation.



    The participant, by signing this agreement, agrees that the Bliss Body Retreat team, guest teachers, and the Retreat villa and their respective representatives, will not be held liable for any injury, damage, loss, delay or irregularity that may be occasioned for any reason, including, but not limited to any defect in a vehicle, the acts or default of any company or person engaged in conveying a participant, acts of God, terrorism, acts of war, or detention; delays or expenses arising from quarantine, strikes, thefts, pilferage, force of nature, civil disturbance, government restrictions or regulations, accidents by aircraft, boat, train, or motor vehicle, or in any restaurant, place of visit or accommodation; failure of any means of transportation to arrive or depart as scheduled or changes to transit; missed airline or other transportation connections; or additional expenses resulting from changes in exchange rates, tariffs, or itinerary.

    The participant agrees to assume all risks associated with the Retreat and agrees that no liability will attach to the Retreat Organizers and Retreat Center, their employees or agents, or to any member of the trip in respect of death, personal injury, illness or delay of the passenger, or for any loss of or damage to the property (including luggage) of the participant during the course of the Retreat, howsoever caused. By signing this Retreat Participation Agreement, the participant releases the Retreat Organizers as well as the Retreat Center and their representatives from any such responsibility or liability, except as herein above set forth. The liability of common carriers is generally limited and, therefore, it is suggested that participants purchase their own cancellation, property damage (including luggage), and accident insurance. For the benefit of everyone on your trip, the Retreat Organizer reserves the right to accept or reject any trip participant at any time without liability, and in the event it determines, in its sole and exclusive discretion, that a participant is disruptive to the harmony of the Retreat, it may without any obligation to pay a refund or any other amount whatsoever, expel such participant from the Retreat. The Retreat Organizers will have no responsibility or liability for any participant who leaves the Retreat prior to its conclusion or for any activity undertaken by any participant that is not included on the Retreat Itinerary.


    1. Cancellation Policy
    2. Yoga, Treatments, and Other Activities Waiver
    3. Retreat Participation Agreement
    4. I confirm I would like your representative to call me and give more information about Bliss Body Retreat events.

    By signing below, I verify that I have read, understand, and agree to all the terms above.

    1. Signature
    2. April 22nd, 2021