Reservation Niru Yoga Homestay - YOGA CLASSES, MEDITATION & PEACE YOGA STUDIOS NEAR KATHMANDU & BREATHE YOGA HIKING IN NEPAL

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About
Retreat Packages
Training Programs
Contact us
- Contact
- Direction/Location
Book Now

Guest Registration and Consent Form

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Name *

First

Middle

Last

Age

Email *

Gender *

Preferred Pronouns

Phone Number *

Home Country *

Passport Number *

Best Form of Contact *

Phone
WhatsApp
Email

Expected Date of Arrival *

Check in date

Expected Date of Departure. *

Check out date

Retreat Package
One Day Wellness Retreat
Yoga and Hiking Retreat (1-30 Days)
10 Day Ayurvedic Detox Retreat
Group Yoga Retreat
Online TTC Classes
5 Day Sound Healing & Meditation Certificate Course
10 Day Prana Shakti Certificate Course

Accomodation Type:
Single Room
Double (with friend)
Double *
*Please note if double room is chosen you may be assigned a roommate during your stay.

Roommate's Name (If coming with someone else):

Additional Night(s) - Shared Room ($60/night)
Note: Additional shared room nights are $60 each. Inform us if you wish to extend your stay.

Additional Night(s) - Single Room ($100/night)
Note: Additional single room nights are $110 each. Inform us if you wish to extend your stay.

How did you learn about us?
Previous Guest(s)
Google Search
Facebook
Instragram
Other Social Network

What do you hope to gain from this retreat (Goals)?

Yoga Experience:
First time doing yoga
Beginner
Intermediate
Advanced
Yoga Teacher

Hiking Experience
Beginner (short flat hikes)
Intermediate (able to walk 3-6 miles in various terrain)
Expert (long treks at higher altitude)

Which style(s)or tradition(s) of yoga have you practiced?

Do you have any chronic health conditions or injuries that may impact your ability to practice yoga or hiking?
Yes
No

If "Yes" please let us know below:

Do you have any allergies or dietary restrictions?
Yes
No

If "Yes" please let us know below:

Participant Consent:
I understand that I must be mindful of my own limitations with respect to yoga and meditation.
I acknowledge it is my responsibility to inform the instructor when I begin a class or hiking of any injury or othercondition that might affect my ability to participate and to inform the instructor immediately if any injury occurs during class.
If at any time I feel that instructions or class/hiking activities present any risk of injury to me, or if I feel tired or otherwise unable to perform class activities I will inform the instructor and refrain from activities in question.
I understand that I must pay for the full cost of my stay before or upon arrival to Niru Yoga Homestay.
I grant Niru Yoga Homestay/Yoga Pathshala the right to take photographs of me during my stay and I authorize Niru Yoga Homestay/Yoga Pathshala to copyright, use and publish the same in print and/or electronically. I agree that Niru Yoga Homestay/Yoga Pathshala may use such photographs of me with for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. (Please noteL: we completely respect your privacy if you choose not to participate in this clause)
I understand and confirm that I have signed this Agreement freely, voluntarily, under no duress. My signature below is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability toward Niru Yoga Homestay, Yoga Pathshala or any affiliates to the full extent of the law.

By providing my signature below, I confirm I have read and understood the statements below and the information provided above is true and correct to the best of my knowledge.
Please enter your full name as your form of signature.

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