ONLINE REGISTRATION FORM FOR KRIYA YOGA INSTITUTE - HOMESTEAD, FL - HIGHER KRIYA RETREAT

The 3-day retreat will begin on Friday, March 6, 2020, 5:30 am, and conclude on Sunday, March 8, 2020, 9:00pm.

* indicates mandatory


Personal Information

First and Second Kriya Initiation Information

When Were You Initiated?

Level Year Month Day Where Were You Initiated? Who Initiated You?
1st Kriya
2nd Kriya Part 1 & 2
2nd Kriya Part 3
2nd Kriya Part 4
Not sure

If you are not certain which level you are practicing, please describe what you are practicing:

Program Package

I would like to register for the full 3-day retreat and will be staying at the ashram. I am sending a check/money order for $200 towards meals, accommodation, and retreat. (To reserve your spot, please send the deposit amount $75.00. The full amount is due by Jan 31, 2020.)
I would like to register for this retreat and will be staying off-site. I am sending a check/money order for $45 per day (towards meals and retreat) for each day that I will attend. I will attend on (please check days): I will attend on (please check days):
  • Friday
  • Saturday
  • Sunday

Please help in our program planning by telling us, as accurately as possible, when you expect to arrive, and when you expect to depart.

I will arrive on (date) at (time)
I will depart on (date) at (time)

Online Registration Terms

Please make your check or money order payable to Kriya Yoga Institute, and mail it to Kriya Yoga Institute, Online Program Registration, P.O. Box 924615, Homestead, FL 33092-4615.

I understand that in the event of a cancellation there will be a $75 non-refundable deposit.

By signing below I agree that I will abide by the code of conduct of Kriya Yoga Institute and will not hold Kriya Yoga Institute, liable for any injuries, illness, or losses that may occur during my attendance, or use of the Kriya Yoga Institute facilities. I agree that Kriya Yoga Institute and its agents, staff, employees, and instructors shall not be liable for any injuries or any damages to any registrant or guest, or be the subject to any claim, demand, injury or damages, whatsoever, including without limitation, those damages from acts of passive or active negligence on the part of Kriya Yoga Institute, its officers, staff, employees or agents. Registrant does hereby expressly forever release and discharge Kriya Yoga Institute from all such claims, demands, injuries, damages, actions or causes of action whatsoever. Registrant acknowledges that he/she has carefully read this paragraph and fully understands that this is a waiver and release of liability. Registrant will at all times indemnify and hold harmless Kriya Yoga Institute, its agents and licensees from and against any and all claims, damages, liabilities, costs and expenses, including but not limited to reasonable legal expenses arising out of my attendance, or use of the Kriya Yoga Institute facilities.