Dancing Shiva Program Registration Form

Please select a Program
Please enter your name
Please enter your address
Please enter your city
Please enter your zip code
Please enter your state
Please enter your country
Please enter a phone number
/ / Please select your birthdate
Please enter your current profession
Please choose career satisfaction
Please enter your email address
Please choose education completed
Please enter your major
Please enter your degree
Please enter year graduated
Please describe your Yoga and Ayurveda experience
Please describe your reasons for taking the program
Please describe your lifestyle
Please choose how many hours you have available

Payment Policy

  • I acknowledge and am confirming that my payments towards this event, course, program or consultation or any service offered by Dancing Shiva or Mas Vidal and all associated faculty are entirely non-refundable. This includes personal reasons or circumstances that I may experience during the timing of the course, program or service is being offered to me.
  • I acknowledge that Dancing Shiva and Mas Vidal are not responsible for my personal issues, behavior or opinions that may result during my participation.
  • When making a payment, I have authorized Dancing Shiva and Mas Vidal to charge my credit card for the purchases listed on the Dancing Shiva website, in program catalogs or as arranged directly via Dancing Shiva staff by phone and or email.

Liability Release

YOU ACKNOWLEDGE THAT BY SIGNING THIS FORM AND/OR PARTICIPATING IN ANY ACTIVITIES OR THERAPIES AT DANCING SHIVA YOGA AND AYURVEDA, CASA TEJAS OR ITS AFFILIATE LOCATIONS YOU HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. YOU ACKNOWLEDGE THAT YOU ARE AGREEING TO WAIVE ANY RIGHT THAT YOU MAY HAVE TO BRING A LEGAL ACTION TO ASSERT A CLAIM AGAINST DANCING SHIVA YOGA AND AYURVEDA OR MAS VIDAL.

Yoga or Ayurveda are no substitute for medical care and offers no health warranties or guarantees of any kind. Always consult a physician before starting any yoga or exercise program.

By choosing to attend events, programs, retreats, classes, consultations, and/or any Ayurvedic therapies or detox programs at Dancing Shiva Yoga and Ayurveda, Casa Tejas or any of its affiliate locations, you agree that if you engage in any physical exercise, activity, use any Dancing Shiva Yoga studio facility, or take any Dancing Shiva Yoga and Ayurveda course or treatment, you do so at your own risk. This includes, without limitation, your use of Casa Tejas its dressing room, bathrooms, swimming pool, hot tub, steam room, showers, parking area, sidewalk, hallway, balconies, stairwell, yoga room, treatment rooms or any equipment used in the studio or in therapies. This also includes your participation in any activity, class program, treatment, or instruction. You agree that you assume all risk of injury, illness, damage or loss to you or your property that might result, including, without limitation, any loss or theft of any personal property. You agree on behalf of yourself (and your personal representatives, heirs, executors, administrators, agents and assigns), to the maximum extent permitted by applicable law, to release and discharge us (and our affiliates, employees, agents, representatives, successors and assigns) from any and all claims or causes of action (known and unknown) arising out of your or our acts or omissions, including negligence.

This waiver and release of liability includes, without limitation, injuries which may occur as a result of
a) your use of any equipment or facilities,
b) any instruction or supervision received while at a Dancing Shiva Yoga and Ayurveda sponsored event, on the Casa Tejas premises, in classes or private sessions with Mas Vidal /or
c) your slipping and falling during an event or on the Casa Tejas premises or wherever Dancing Shiva is hosting its courses, programs or retreats.

Please accept the terms and conditions
Please sign the form
Note: Both you and Dancing Shiva will be emailed a PDF file with the above payment policy and your signature from this form on it. This is considered a binding contract between you and Dancing Shiva.