Casa Om, Potomac · August 28–30

Reserve Your Spot

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Contact Information

Full Name *

Email *

Phone *

Address

City

State

Zip

Name

Phone

Relationship

Roommate Name (if sharing)

Rooming Preference

I'll be in my own room

I'm sharing with someone listed above

I'd love to be paired with a roommate

Yoga Experience *

Beginner

Some experience

Regular practitioner

What draws you to this retreat?

Dietary Restrictions / Allergies

Would you be interested in any of the following?

Select all that apply — each is available for an additional fee.

Massage

Guided Cave Hike

Ice Bath

How will you be paying?

Venmo, Zelle, and check are preferred — save $10 per payment when you use one of these.

Venmo ✦ preferred

Zelle ✦ preferred

Check ✦ preferred

Cash

Credit Card

Anything else you'd like Katy to know?

Submitting this form is not a payment. Katy will follow up with deposit instructions to secure your spot.