Form – My Blog

First Name *

Last Name *

Email Address *

Phone *

Billing Street Address *

Apartment, suite, etc

Billing City *

Billing State *

Billing ZIP Code *

(optional) If you would like your pronouns listed on your name badge, please enter them here.

Emergency Contact Name & Relation *

Emergency Contact Phone *

Registration Type *ParticipantPresenterAmbassador

Will you be attending the full retreat (3 days) or do you need day passes? *Full RetreatDay Passes

Day Passes *Friday ($145)Saturday ($350)Sunday ($235)

Day Passes – Fri onlyFriday ($145)

Day Passes – Saturday onlySaturday ($350)

Day Passes – Sunday onlySunday ($235)

Will you be staying overnight? (2 night requirement) *YesNo

Will you be arriving after 8pm on Friday? *YesNo

What time will you be arriving? *

Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Select One

Bath for Shared Room (for 2 Nights) *Private Bath (+$30)Common Bath (no added fee)

Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Private ($290)Select One

Bath for Shared Room (for 2 Nights) *Common Bath (no added fee)

Bath for Private Room (for 2 Nights) *Common Bath (no added fee)

Bath for Private Room (for 2 Nights) *Private Bath (+$40)Common Bath (no added fee)

2nd choice Room (for 2 Nights) *3+ Person ($240)2 Person ($270)Private ($290)Select One

2nd Choice Bath for Shared Room (for 2 Nights) *Private Bath (+$30)Common Bath (no added fee)

2nd Choice Bath for Private Room (for 2 Nights) *Private Bath (+$40)Common Bath (no added fee)

If you have a preference for your roommate(s), please list their name(s) here. If not, enter NA. *

Do you have any MEDICAL dietary restrictions or food allergies that we need to know about? *YesNo

Please list your MEDICAL dietary restrictions or food allergies. *

Are they LIFE THREATENING? *YesNo

How did you learn about Texas Yoga Retreat (TYR)? *

Who referred you? *

If you are commuting to and from the ashram versus staying overnight on site, you will be automatically charged for the 3 days of the retreat (Friday, Saturday, and Sunday). If you are not commuting all 3 days, you will need to input a discount code in the box below to avoid the full 3-day charge. If you are commuting one day, use code COMMUTE1; if you are commuting two days, use code COMMUTE2.

Do you have a discount code? *YesNo

Discount Code (for Participants only) *

Discount Code (for Presenters/Ambassadors only) *

Check here if applicable (must select to get discount) AMB2025 *100% Discount

Check here if applicable (must select to get 10% discount) *10% Discount

Check here if applicable (must select to get ALUMNI discount) *$75 Discount

What year(s) did you previously attend the Texas Yoga Retreat? *

Check here if applicable (must select to get Accommodations discount) *$40 Discount

Check here if applicable (must select to get OliviaM discount) *575

Check here if applicable (must select to get discount) staff2025 *100% Discount (Staff2025)

Check here if applicable (must select to get discount) ANANDA *20%

Check here if applicable (must select to get discount) presenter2025 *50% Discount

Check here if applicable (must select to get COMMUTE1 discount) *$40 Discount

Check here if applicable (must select to get COMMUTE2 discount) *$20 Discount

Check here if applicable (must select to get discount) COMMUTEFREE *100% Discount on Commute

Check here if applicable (must select to get discount) LYP15OFF *15%

Check here if applicable (must select to get discount) GRP15OFF *15% discount for groups of 3 or more

Please list the name of each person in your group who will be attending using this discount code *

For those in the Hybrid Ambassador program, how much money can you pay toward your retreat fees? (type 0 if not applicable) *

Retreat Registration Fee

Early Bird Registration Fee

Day Pass Registration Fee

Accommodations Fee

Meals Fee:

Commuter Fee 3 Days (for ambassadors not staying overnight on ashram property)$60

Commuter Fee 3 Days (for participants not staying overnight on ashram property)$60

Discount

Total

How do you want to pay? *ZellePaypal/Credit Card

Zelle info

Your registration is not confirmed until you log into your bank to complete your payment. Send your payment to texasyogaretreat@gmail.com. Texas Yoga Retreat is enrolled with Zelle as Living Yoga Program LLC.

Payment options

Zelle
This is our preferred gateway for donations because it is a bank to bank transfer and does not require any fees.

Credit/Debit Card without a PayPal Account
For anyone who wants to use a credit/debit card that is not connected to a Paypal account.

PayPal
If you already have an established PayPal account (or want to set one up).

Take a moment and pause….have you applied your discount code (if you have one)? Remember…discount codes cannot be applied retroactively.

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Visibility conditions for Full Retreat or Day Pass option: Show if All –>Day pass reg fee less than $380 and greater than $0

For Staff Use Only