Rolf Gates: master yoga teacher & author
For more information, please contact Program Coordinator, Deidre Ostrowski at
(617) 504-6505 or deidre@rolfgates.com.

 
 

This week is an “intensive” and therefore is intentionally challenging. It is ideal for those in their first couple years of practice as well as more seasoned practitioners. Six months of regular vigorous practice is suggested.  For those with less than 6 months experience, we will offer support regarding how to best prepare.
CONTACT INFO
First Name:   Last Name:
Street Address: 
City:   State:
Zip Code:   Country:
Daytime Phone:    Evening Phone: 
Email:      
 
Company:   Job Title:
Occupation:   Marital Status: 
Age:   Gender:


PHYSICAL HEALTH
Under physician's care? Yes   No
If yes, for what reason?  
Epilepsy? Yes   No
Diabetes? Yes   No
Are you currently seeking mental health care? Yes   No
If yes, for what condition?  
Please list any current medications:    
Have you ever been hospitalized? Yes   No
If yes, for what condition?  
Do you have any dietary requirements?    
Are you a smoker? Yes   No
Do you use drugs ? Yes   No
Do you drink alcohol ? Yes   No
What is the frequency in these areas?   
What is your past history with yoga practice? Please include any previous workshops or intensives with Rolf Gates.


INTENTIONS FOR THE RETREAT
lease take a moment to tell us a bit about why you are choosing this retreat at this moment. What are your intentions here for yourself in this experience?
Please comment on where you are in your life (what is working and what is not) in the following areas:
(For those of you who are coming back for the second and third (and fourth) times, we ask that you be sure and still take time on these questions to better refine your intentions for this week.)


ROOMING PREFERENCE (subject to availability)
Shared House: $1,500
  (7-10 people)

Shared Room: $1,650
  w/shared bath (3-4 people)

Shared Room: $1,725
  w/shared bath (double occupancy)

Single Room: $1950
  w/private bath (single occupancy)

 

Upon your acceptance you will be charged a non-refundable $500.00 deposit. Final payment is due prior to the start of the retreat.

Refunds (less the $500 deposit) are only available 60 days prior to the event.