Online Registration

You are registering for:

Program:: Ashtanga Yoga Teacher Training
Dates:: September 13-20
Presenter:: MMC Senior Yoga Teaching Staff

Registrant Information

* First Name:
* Last Name:
* Gender:
1. Female
2. Male
* Street Line 1:
Street Line 2:
* City:
* State/Province:
* Zip/Postal Code:
Country: Defaults to USA
* Home Phone: At least one phone number is required
Work Phone:
Cell Phone:
* Email:
* Email Again: Repeated to be sure it is right

Continuing Education Credits

If you are a nurse and wish to receive a CEU certificate
License #: Like this: RN98765.
If you only want a certificate of completion enter COMP for the license #.

Housing Choice

* Please indicate your first and second choices for housing:

We will do our best to honor your first and second preferences. If neither is available, we will assign the next best option, and waitlist you for your choices.

1st	2nd	Housing
		Commuting
		Own Van
		Own Tent
		Center Tent
		Dormitory
		Triple
		Double
		Double w/ Bath
		Single
		Single w/ Bath

If you have a physical disability that limits where you can be housed, please note this in “Additional Requests” below.

If given a choice, would you prefer a cabin or a room?
What's the difference?
1. Cabin - heat and electricity, but no indoor plumbing
2. Room
If you wish to share your housing with someone, put their name here:
1. First ← Make sure that they register separately.
2. Last

Additional Requests

Include the following in your additional requests:

The ages of children you are bringing, if any.
Arrival and/or departure dates if they differ from your program's.

Important Notes

Balance is due on arrival (Visa, MasterCard, cash or check only).
The $500 deposit will be taken upon registration. If one cancels 14 or more days prior to the beginning of the program, $400 will be refunded. If one cancels within 14 days from the beginning of the program there will be no refund or credit. Housing and date changes incur a $20 fee.
This form does not automatically reserve your spot for the program. You are not registered until we receive your deposit. If the program is full, your deposit will be refunded.
Housing is not always available. Do not finalize your travel plans until you have received a housing confirmation from Mount Madonna Center.
We will be sending you a confirmation email. Don't let it end up in your spam folder. Add the following addresses to your list of acceptable emails: reservations@mountmadonna.org and programs@mountmadonna.org.