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14102 Schiller Road, Houston, TX 77082
Phone: 281-596-YOGA (9642)
email: info@jvbhouston.org
Registration Form
19th Annual Family Camp
at Radha Madhav Dham, Austin, TX
Friday, April 19, 5:30 pm to Sunday, April 21, 12:00 pm
*
First Name
[$125/person]
*
Last Name
Address
City
State
Zip
*
Phone
Alternate Phone
*
Email
Additional Registrants:
Adult 2
[Add $125]
Adult 3
[Add $125]
Adult 4
[Add $125]
Total Adults
One - $125
Two - $250
Three - $375
Four - $500
Children (age 12-17):
Child 1
[Add $50]
Child 2
[Add $50]
Children (age 2-11):
Child 3
[Add $50]
Child 4
[Add $50]
Total Children
None
One
Two
Three
Four
Garden Room Upgrade Requested (additional fee applies at check-in. LIMITED AVAILABILITY)
I/We have read and agree to the Terms and Conditions.
Terms and Conditions:
I hereby stipulate that I am physically sound to proceed with instructions in Preksha Meditation and Yoga. It is further agreed that all exercises and lessons shall be undertaken at my own risk and that Radha Madhav Dham and JVB Preksha Meditation Center shall not be liable for injuries, damages or claims to myself or my property arising out of, or connected with, the use of services or facilities of Radha Madhav Dham and JVB Preksha Meditation Center or the or the premises in which the same is located. Radha Madhav Dham and JVB Preksha Meditation Center accept no responsibility of any kind for the Meditation and Yoga activities. I do hereby release and discharge Radha Madhav Dham and JVB Preksha Meditation Center from all such causes of action.