Holistic Healing & Yoga Summer 2016 Retreat Program Enrollment & Waiver

~2pm August 6th,2016–11am Aug 12th, 2016~

On this date, ______, Holistic Healing & Yogaand

______enter into the following agreement.

(Full Name of the Participant)

I plan to arrive at Pura Vida Spa (nearest airport San Jose International Airport, Costa Rica (SJO) on 8/6/2016 and depart on 8/12/2016for a total of six nights stay at Pura Vida Spa for the Holistic Healing & Yoga Summer 2016 Retreat with Kyung Yi-O'Kelly and Clarissa Burnham, the hosts for the retreat. The flight detail is to be forwarded to Kyung by not later than 7/24/2016.

I understand that participation in this event is strictly voluntary and involves physical exercise. I understand that physical activity poses some risk of physical injury and that I may want to consult with my physician before participation. I understand that participation in this activity should be according to my physical condition. I hereby voluntarily assume all risk of injury during my participation and expressly and forever release and discharge Holistic Healing & Yoga and its associates, instructors, and agents from all claims, demands, and damages resulting from my participation.

Please see the Retreat rates list below for the available Room type and Occupancy type.

2016 Holistic Healing & Yoga Summer Retreat at Pura Vida Spa Costa Rica

~If enrolled before July5th, 2016 and there are 7 or more participants~

Occupancy / DBL per person / SGL
Tentalow / $1075 / $1280
A-Frame / $1240 / $1565

2016 Holistic Healing & Yoga Summer Retreat at Pura Vida Spa Costa Rica

~If enrolled after July5th, 2016 and there are 6 or more participants~

Occupancy / DBL per person / SGL
Tentalow / $1250 / $1475
A-Frame / $1425 / $1765

2016 Holistic Healing & Yoga Summer Retreat at Pura Vida Spa Costa Rica

~If the total number of participants is 5 or less~

Occupancy / DBL per person / SGL
Tentalow / $1520 / $1725
A-Frame / $1785 / $2010

(NB In the event that the total number of participants is less than 5 (i.e. 4 or less), the retreat will be hosted by Kyung Yi-O’Kelly only without the 2nd host Clarissa Burnham and the evening practice of sound healing sessions will be replaced by partner healing sessions)

These rates include: accommodations, buffet-style meals, round-trip airport transfers, taxes, 6x120minGroup Holistic Yoga & Meditation sessions plus 1 hr Morning andEvening practice sessions,

Special Offer to include two half day adventures and San Jose City Tour ends on July 5th, 2016. After that, there will be additional charge of $250.

RETREAT RESERVATION TERMS

  • A non-refundable deposit of $250 accompanies this agreement in order to hold the chosen room & occupancy type ______
  • A 40% non-refundable deposit based on rooms reserved in amount of $______ is due and payable 30 days prior to your arrival date on __7/6/2016__.
  • The remaining balance based on rooms reserved in amount of $______is payable by 7/29/2016.
  • I understand that my email address will be forwarded to Pura Vida Spa as they require emails for all guests who will be staying there due to post 9/11 travel industry standards and so that they can communicate with guests in the event of flight delays, cancellations and weather complications.
  • Guests may book a shuttle to and from the San Jose International Airport (SJO). Go to and click on “About” in the navigation bar. The shuttle request form is located in this page.

CANCELLATION POLICY

If you choose to cancel your retreat, all monies that we have received will be non-refundable. However, you have 12 months from the date of cancellation to use your deposit towards a personal vacation to any of the three Pura Vida resorts. Exceptions are for a death in the family or medical necessity. Holistic Healing & Yoga reserves the right to cancel retreats at any time if there is concern with lack of reservations and will refund 100% deposit money if it elects to do so within 10 days of the notice date.

PAYMENT INFORMATION

Paid by: [] Visa [] Master []Amex [] Check (payable to HHY) [] PayPal (send money to ) [] Venmo: User name:______

Name on the card: ______

Credit Card Type: VISA , MASTERCARD or AMEX Card Number______Exp Date______SVC#______

Billing Address: ______City: ______State: ______Zip Code: ______

Phone: ______Alt Phone: ______

Signature by the applicant: ______Date: ______

Signature by HHY: ______Date: ______

Holistic Healing & Yoga * 6000 Shepherd Mountain Cv 1610 Austin, TX 78730 * 469-878-9441

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