Fake Yoga- (Jade Southard WI)

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1 Welcome

3 People in your group

Guest 1		First Name* Last Name* Email* Meal selection*
Guest 1		First Name* Last Name* Email* Meal selection*

After completing this form, emails will be sent to everyone in your group to complete their information.

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5 Bedding rental (optional)

If booking for yourself and others on this form, please choose items for all members of your family/group.

Bedset - individual

Includes: 1 flat sheet, 1 pillow, 1 light blanket, 1 fleece blanket, & 2 towels

$30.00

Select quantity

Bedset - couple

Includes: 1 flat sheet, 2 pillows, 1 light blanket, 1 fleece blanket, & 4 towels

$35.00

Select quantity

Blanket only set

Includes: 2 blankets (1 light blanket & 1 fleece blanket)

$9.00

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6 Tell us about yourself

Please provide information that will help us prepare for your visit.

Meals at Breitenbush	Meals are included in your stay; you can enjoy dinner on your arrival day, breakfast and lunch on your departure day, and every meal in between. Our meals are vegetarian and served buffet style. Meal times are as follows; breakfast is 8:00-9:00 am, lunch is 1:00-2:00 pm, and dinner is 6:00-7:00 pm. We are unable to offer meals early or set meals aside. Please note: we cannot accommodate dietary restrictions other than the “special diet” option below (select that option to see more information) and cannot accommodate serious food allergies, as all food is prepared in the same kitchen.
Meal selection *
About "special diet"	Our “special diet” meals are egg, dairy and gluten free (may contain trace amounts of gluten). This is the extent of our ability to meet our guests’ dietary restrictions. In addition to egg, dairy, and wheat, we routinely cook with soy, corn, nuts, mushrooms, nightshades, sugar, yeast, garlic and onion in our kitchen. If you have a very strong sensitivity to any of these allergens, you can check the ingredients for each meal listed in a folder in the dining room. Regardless, trace amounts of allergens may still be present in the meal. Selecting "special diet" for your meal selection lets our kitchen staff know to have a gluten-, egg-, and dairy-free portion available for you on the buffet. You are welcome to choose which buffet dishes you serve yourself.
First time visitor to Breitenbush? *	Yes, this will be my first visit No, I've been to Breitenbush before
How did you hear about us?
Other source	If you indicated that your found us through another source, please tell us more.
Do you identify as...
BIPOC discount	Enter the discount code BIPOC10 below to receive 10% off the lodging price for this reservation.
Veteran discount	Enter the discount code VETERAN10 below to receive 10% off the lodging price for this reservation.
Wisdom discount	Enter the code WISDOM10 below to receive 10% off the lodging price of this reservation.
Discount code
Email newsletter	Please send me the email newsletter
Anything else you would like to tell us? [Optional]	Questions about this program or the registration process? Recommendations for a future program? Comments about how Breitenbush has impacted your life?

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7 Read the fine print

Limited services *	I understand that cell phone signals do not reach Breitenbush and that Breitenbush does not provide internet or phone access, except in cases of emergency. I understand electricity is very limited.In addition to no access to phones or internet, Breitenbush generates its own electricity from the Breitenbush River with limited capacity. Please do not bring devices that consume high amounts of electricity, such as electric teapots, hair dryers or hot plates. CPAP machines are okay.
Remote location *	I understand that Breitenbush is at least one hour from medical services, and is also far from the conveniences of civilization.Please be aware, especially if you have a chronic or acute medical condition, that emergency services have about an hour response time to our location, with another hour drive to a hospital. While we offer some basic items in our gift shop, please be sure to pack anything you may need during your visit.
Check in & out times *	I understand that I must arrive at or after 3:00 pm on my arrival day, and my lodging will be ready at 4:00 pm. I understand I must vacate my lodging by 1:00 pm on my departure day.We have Early Soaking passes (previously called Early Arrival) available for most arrival days - there will be a link to book in your confirmation email. If you have not vacated your lodging by 1:00 pm or property by 3pm on your departure day there will be a $20 late fee charged to your credit card.
No pets *	I understand that Breitenbush does not allow pets on the property.This policy is intended to benefit the health and safety of all of our guests, to protect the wildlife, and to maintain a retreat atmosphere on the property. If you require that a registered service animal accompany you please contact our office in advance of your arrival.
Prohibited items *	I understand that Breitenbush prohibits recreational drugs, alcohol, any open flames, and firearms. I agree not to bring these items to the property.Alcohol and recreational drugs (including marijuana) are not permitted. There is an outdoor covered area where tobacco smoking is permitted - smoking and vaping in lodgings is strictly prohibited. Please no candles, incense, camp stoves, etc. A $20 deep cleaning fee will be applied for violating this policy.
Vegetarian center *	I understand that Breitenbush is a vegetarian center, and does not serve meat products. I agree not to bring meat products into the Lodge.We serve only organic vegetarian meals in our dining facilities and request that meat or fish not be eaten in or around the Lodge. We do not serve caffeinated beverages with meals, though you may purchase them in the gift shop. We provide hot water and filters for your use if you bring your own coffee or tea.
Swimsuits optional *	I understand that swimsuits are optional in the soaking pools and sauna. I will help to maintain an atmosphere of sanctuary, inclusivity, and respect. The use of electronic devices is prohibited in the bathing areas.Breitenbush celebrates the dignity of the human body in all of its diverse forms. You may soak nude or in a swimsuit - please do what feels most comfortable for you. The clothing optional policy does not extend beyond the pools.
Policies and FAQs *	I agree to abide by Breitenbush policies, including the cancellation policy, and have read the FAQs.View the Breitenbush policies, reminders and other important information. These FAQs will help you prepare for your visit. In particular, be sure to review our cancellation policy, digital detox policy, and quiet hours policy.
Event Cancellation Policy *	I understand that the cancellation policy for this event differs from the Personal Retreat & Day Use cancellation policies.Cancellation and refund requests submitted at least 14 days prior to the start date of this event will be accepted, and the full balance will be refunded minus a $100.00 service charge. Requests submitted less than 14 days prior to the start date of this event will be accepted, but a refund will only be applied if the space can be filled either by a new registration or from the event waitlist. The $100.00 service charge will still be collected.
Waiver of liability *	I acknowledge that due to the 2020 wildfires, there are areas of Breitenbush property that were heavily burned and are potentially hazardous, and are therefore off-limits to guests.While Breitenbush has made every effort to identify and cordon off such areas, every guest, resident and employee must exercise due diligence in looking out for their own safety and staying in safe areas of the property. You hereby agree to stay out of designated areas and to exercise caution while on the property.

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8 Make a difference

$	Rebirth, Repair, then Rebuild! The love and support from people who care about Breitenbush Hot Springs keep us going. You are the heart of Breitenbush; without you, we could not rise from the ashes, much less thrive. We appreciate you. We love you. And we look forward to welcoming you. Unfortunately, your donations to this cause are not tax-deductible. Your gift is greatly appreciated and will make a difference for Breitenbush and all who come to enjoy the healing waters.

9 Confirm your booking

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In celebration of the experience of life.

PO Box 245, Idanha, OR 97350 USA
53000 Breitenbush Rd SE, Detroit, OR 97342 USA
office@breitenbush.com

1 Welcome

2 Choose a lodging and meals package

Select an option*

The Grove (1 queen bed)

The Grove (1 full bed + 1 twin bed)

The Grove (1 full bed + twin bunk)

Lodge Room (1 full bed)

Milky Way (1 twin bed)

Milky Way (twin bunk bed)

Mushroom Yurt (2 queen beds)

Forest Shelter (2 queen beds)

Sundial Yurt (2 queen beds)

Bell Hotel (1 queen bed)

Personal Vehicle Site

3 People in your group

4 Additional Programs

Participants

5 Bedding rental (optional)

6 Tell us about yourself

7 Read the fine print

8 Make a difference

9 Confirm your booking