Name *

First Name

Last Name

Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What cabin would you like? *

Single- $220/night

Double- $240/night

Double w/ 2 people- $300/night

Emergency Contact *

Name

First Name

Last Name

Emergency Contact Phone Number *

(###)

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I understand that all payments and fees are non-refundable. *

By checking this box, you agree that once booked and paid for, all payments and fees are non-refundable. If you cannot make your retreat time, please inform us as soon as possible so we can accommodate another guest.

I agree

Waiver *

WHEREAS I am about to take part in a retreat on the property of Chamma Ling, P.O. Box 608, Crestone, Colorado at the dates named above, and whereas I am doing so entirely upon my own initiative, risk and responsibility. Therefore in consideration of permission extended to me by Britt Bradford LLC and Chamma Ling to take part in this program I do hereby, for myself, my heirs, personal representatives and assigns, remise, release and forever discharge Britt Bradford LLC and Chamma Ling and all of its officers, agents and employees, acting officially or otherwise, from any and all claims, demands, actions or causes of action on account of any injury to me or my property or my death, which may occur from any cause during said program or in connection with any activities incidental thereto, and I further do hereby, for myself, my heirs, personal representatives and assigns, remise, release, forever discharge and agree to hold harmless and to indemnify and defend Britt Bradford LLC, Chamma Ling and all of its officers, agents and employees, acting officially or otherwise, against any action or demand by any of my children, invitees or guests, or by any other person or persons for damages on behalf of such children and to further hold harmless, and indemnify and defend from any and all claims alleged to or caused or resulting from my participation, my acts or omissions, and/or such alleged to or caused by my children, invitees or guests. I further authorize Britt Bradford LLC and Chamma Ling to arrange emergency medical care for me should it become necessary to do so in the event of personal injury to me. I agree to be fully responsible for the costs of any such treatment.

I agree. By checking this box, I digitally sign this waiver on the date the form is submitted.