All ages under 18 MUST HAVE a liability waiver signed by their parent or legal guardian. EVERYONE MUST HAVE a waiver initialed and COMPLETELY filled out. Ages 18+ must provide a valid drivers license.

Agree and Acknowledge

I understand and acknowledge that if I proceed to register on line and to sign the waiver electronically that such electronic registration and electronically signed Waiver document will be valid and enforced in the same manner as a hand-signed document that exists in physical form and that a record or signature may not be denied legal effect or enforceability under law solely because it is in electronic form.

Basic Information

Use parent or guardian information if under 18

Contact Information

Use parent or guardian information if under 18

Registration $325
Early bird rate is $275 prior to July 15 (10% off each person when registering together)

Accomodations, some meals, and transportation are not included in the registration fee.

Full payment is required to reserve your space. Send this completed form and check to Karen Callan,
4500 N Santana Place, Tucson, Az 85750.
If paying with charge card, an added 3% fee will be charged.

Cancellation Policy: If you should have to cancel unexpectedly, the program fee is fully refundable minus a $25 processing fee. If you cancel with less than 72 hours before the retreat, 50% of your retreat fee will not be refunded, but may be used towards future classes with either Holly or Karen.

We reserve the right to cancel programs, retreats and workshops with inadequate enrollment – (we typically try to notify you no less than 21 days of the event). In the case of cancellation, all deposits and any balances paid will be refunded in full. We are unable to refund any transportation, flight or other incidental expenses incurred.
My signature below indicates I understand this policy.

Disclaimer: My decision to participate in the Reflection of Ourselves Retreat is a personal decision. I haven’t been made any promises or warranties that I will receive any benefits or specific results. I understand that yoga and NIA are not substitutes for treatment or services ordinarily provided by health care professionals. I also understand that any instruction given to me during the course may not be appropriate for others. I hereby agree to hold Holly Sack of NIA and Karen Callan and RosaYoga, harmless in any claims brought by me, or on my behalf, which contradict the above.
My signature below constitutes my acceptance of the conditions expressed in the agreement.

Personal Property:
Holly Sack and Karen Callan do not accept responsibility for loss of or damage to your personal belongings, such as baggage or money. We advise against bringing items of value, such as expensive jewelry.

Right of Publicity:
Participation in the Activity shall constitute permission to use the name, likeness, voice or any other identification of the Participant for advertising, publicity, instructional or any other purposes in connection with the Activity or the business of any of the Releasees, in any medium, at any time and from time to time, without compensation to or right of prior review or approval by the Participant. Each Participant, for himself/herself and his/her personal representatives, executors, administrators, heirs, next of kin and assigns, hereby releases and discharges each Releasee from, waives in respect of each Releasee, covenants not to sue any Releasee for, any and all Liabilities arising from, based upon or relating to any claim for invasion of privacy, violation of right of publicity, defamation or appropriation, or any similar claim in connection with any such use.

The Participant represents that the Participant is in good physical condition, is physically fit to participate in the Activity and is not subject to any medical condition that poses or may pose any risk of harm or disability to others.


By entering my name below and clicking the “Submit Waiver” button below, I indicate my acceptance and delivery of this waiver and release. I acknowledge that I have been given an opportunity to prevent or correct any error in connection with this waiver form. If I have submitted this waiver form in error, I will immediately notify you of the error, revoke my signature as instructed, and refrain from participating in any event or activity to which the waiver applies.