Email Address:

Your First and Last Name:

Phone Number (incl. country & area code):

I am applying for:

What is your occupation?:

What is your gender?

(All are welcome. We can't always tell from your name if you're male or female. :) Please let us know so our teachers can be sensitive to your gender identity.)

How do you plan on attending this retreat?

What experience do you have with Sanskrit and/or mantra? (None is required.)

What is your musical background? (None is required.)

Do you have any physical issues, illnesses, or injuries that we should be aware of since we will be doing our practices sitting on the ground or for any yogāsana? Or any medical issues that would affect your hearing or voice?

Emergency Contact Person 

(Name, relationship to you, location, phone number, and email address)

Acknowledgement of Responsibility and Waiver of Liability:

All participants in yoga, mantra, physical training activities and counselling/mentoring with Anandra George (and others who may be designated as teachers/facilitators) acknowledge that they have determined on their own that they are capable of undertaking the activities presented and will use their own judgment in deciding to participate or not participate accordingly.  The undersigned agrees to the above and waives any claim of liability on the part of the above mentioned hosts/teachers/presenters/facilitators in relation to the undersigned’s participation in the activities presented, and in any outside activities undertaken by the participant, and any incidents that may occur at the teaching venue or at any other location while participating in this retreat, training, class or workshop.

Acknowledgement of Cancellation Policy

There is a non-refundable $250 administrative fee.  Students will receive a 50% refund of remaining tuition if requested 30 days or more before the course. No refunds will be issued less than 30 days in advance.  Submission of your payment indicates your acceptance of the cancellation policy.

Please acknowledge that you have travel insurance, or that you are aware that any and all medical service costs, for any reason, including medical transportation costs, will be your sole responsibility.

Your Electronic Signature & Date of Signing

Your signature formally acknowledges responsibility and liability waiver, and the cancellation policy in the previous questions

Do you have any other special needs or requests?

Are you looking forward to immersion in the Heart of Sound on Kaua'i, Hawai'i? ;)