Waiver Full Name* Nickname Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail* Birthdate* (if you don’t want to provide your birthdate, please provide your age)Occupation Retreat you are attending (please include dates - we have many Cowgirl Yoga retreats, so don’t just write “Cowgirl Yoga”!):Emergency Contact InfoName Relationship PhoneRetreat QuestionnaireHow did you find out about Big Sky Yoga Retreats?Roommate RequestWe will match you with a roommate if you are traveling solo; otherwise please indicate that you have booked a single room. If you are coming with a friend/partner and plan to room together, please put her name here.Are you celebrating something on this retreat?(birthday, big life event)? We’d love to help you celebrate!Medical & Dietary InfoDo you have any health issues/medical conditions that we need to know about?YesNoIf yes, please explainDo you have any specific injuries that we need to know about?YesNoIf yes, please explainAre you taking any medications?YesNoIf yes, please explainAre you a vegetarian?YesNoAre you a vegan?YesNoDo you prefer Red Wine White Wine Beer Don’t drink alcohol Do you have any food allergies or restrictions?YesNoIf yes, please explain Tell us about your food preferences too (i.e. can’t stand chicken, love any kind of beans, etc.) the more specific you are, the better! Please note: we will accommodate all dietary restrictions. Every effort will be made to accommodate dietary preferences, but sorry, we cannot guarantee it, especially if your list is long or complicated.Fitness InfoPlease contact us if you have any questions about your ability to participate in activities. We suggest that you consult your physician about participating following any serious illness or injury. We strongly recommend that you use the time prior to your retreat wisely to increase your fitness level so that you can get the most out of your active vacation.Describe your current fitness routineInclude the activities you participate in (running, weights, swimming, cycling, pilates, etc.), the frequency with which you participate in each activity (how often, how far, how long), how long you have been doing each activity, and any other relevant info.What is the main goal of your current fitness routine?(weight loss, stress reduction, feeling good, etc.)Please give us more detailed info on your yoga experienceWhich styles do you enjoy most, have you attended other yoga retreats, are you a yoga teacher, etc. Otherwise please indicate that you are a beginner.Please check box: I understand that we will mostly practice vinyasa flow yoga, which is a challenging and vigorous style. I understand that it would be optimal for me to take a few flow classes in my area prior to the retreat, and that it is important to have a strong fitness level in order to practice this style. Do you have any specific health and fitness goals you’d like to share with us?Your Nordic ski experience beginner intermediate advanced For yoga and ski retreatsDo you have previous riding experience?YesNoFor Cowgirl YogaTM retreatsIf yes, please describe for how long, what style, etc.Please check box: I understand that there are weight restrictions for horseback riding, for safety reasons. In general, 175-195 lbs. is our max (also depending on your height). Please check box: I understand that we will be hiking at high altitudes and this requires working towards a strong cardio fitness level prior to the retreat. For yoga and hiking retreats:Have you ever experienced altitude sickness before?YesNoYour IntentionWhat do you hope to get out of this retreat?Please share your intentions, goals, hopes and dreams, etc.!Do you have any questions or concerns?(please call if you would like to discuss.)Is there anything else that you would like us to know about you? Δ