AGREEMENT FOR PARTICIPATION - Awakening The Energy Body Retreat-Ray Of Light Yoga

AGREEMENT FOR PARTICIPATION - Awakening The Energy Body Retreat

We welcome you to this retreat, please complete this enrolment form and waiver. We can't wait to share this incredible experience with you in blissful North Bali. We would love to hear from you if you have any questions please call or email. Rachel - rayoflightyoga000@gmail.com 0414 585 688 Flo - flo@intouchyogabyronbay.com - 0418 441 437

First name

Last name

Phone Number

Address

Date of Birth

Please share your gender/ pro-noun

Please share a with us a little about your yoga practice and yoga teaching experience.

What calls you to this retreat? Do you have any specific interests or areas you want to deepen into personally and or professionally?

Booking process to reserve your space

A 50% deposit to reserve your space - please note this is non-refundable
Two options are available 6 night 21st - 27th June or 10 nights 21st June - 1st July
All final payments due by latest 21st March 2025
Please discuss your payment needs with us

Twin share room

10 nights $3349

6 nights twin share $2999 21st - 27th June

Single room (limited number available)

10 nights : $3699

6 nights private room $3299 21st - 27th June

Once you submit this form one of your hosts will be in touch. Please indicated what payment option we can invoice your for

Other - i'd like to discuss with Rachel or Flo

We acknowledge that people do not plan on canceling their retreat, but unforeseen circumstances sometimes arise. Cancellations that occur more than three months prior to the retreat start date will be refunded minus your $1000 deposit. Cancellations that occur at or after this time cannot be refunded unless a student can be found to take your place. We recommend that you search for travel insurance that matches your risk tolerance. If necessary, you can consider finding a replacement travel companion. By transferring your deposit or paying for the trip in full, you indicate your agreement to these terms.

We have the right to cancel events with two week's notice due to illness or unforeseen circumstances and will not be liable for costs incurred.

PLEASE NOTE: This is an important document which affects your legal rights and

obligations. Please read it carefully, answer all questions, sign and return the

completed waiver before the commencement of the retreat.

1. Do you have any pre-existing medical conditions? If yes, please specify.

500

2. Do you ever experience pains in your chest at rest or during physical activity?

500

3. Do you ever feel faint or have spells of dizziness during physical activity that causes you to lose balance?

500

4. Do you have any diagnosed muscle, bone or joint problems? If so, please specify which part of your body.

500

5. Do you have any known medical condition(s) that may make it dangerous for you to participate in physical activity?

500

6. Do you have and dietary requirements or food allergies?

500

7. Any serious health issues or surgery in the last year?

500

8. Do you take regular medication(s)? If so, please specify what medical condition the medication(s) are taken for? And will you be taking the medication(s) on the Yoga Retreat?

500

9. Can you swim?

500

10. Please indicate here if you have any past or current mental health issues? Please share if you are taking any medications.

AGREEMENT FOR PARTICIPATION IN Awakening the Energy Body Retreat.

*Please note Awakening the Energy Body, North Bali includes all

activities; accommodation, meals, daily embodiment & yoga practices, sacred ceremonies, meditation, and specialized workshops.

● I have read and agree to the booking terms and conditions.

● I acknowledge that it is a condition of participating in this activity that I do so at my

own risk.

● I accept all risks and hereby indemnify and release Awakening the energy body

Immersion, the retreat/immersion leaders, their agent(s) affiliations, sponsors,

promoters and any person or body directly and indirectly associated with this retreat, against all liability (including liability for their negligence and the negligence of others directly or indirectly associated with Awakening the energy body Immersion) claims, demands and proceedings arising out of or connected with my participation in this activity.

● I accept that the retreat/immersion

leaders and/or other staff are not liable for lost or stolen property.

● I acknowledge that participating in this retreat/immersion may involve a risk of serious injury or even death from various causes, including but not limited to: overexertion, dehydration, accidents, food, animals, people and my surroundings.

● I attest that I am physically fit to participate safely in this retreat/immersion and that a qualified medical practitioner has not advised me otherwise.

● I am not aware of any medical condition, injury or impairment that will be detrimental to my health if I participate in this retreat/immersion. In the event that I become aware of any medical condition, injury or impairment that may be detrimental to my health if I participate in this retreat/immersion, the retreat leaders and/or staff will be immediately informed. By continuing to participate in this retreat/immersion, I accept the risks despite these conditions and still, and will always be under the terms of this agreement.

● I acknowledge this retreat/immersion includes hotel accommodation. I accept I will

stay at this type of accommodation at my own risk.

● I acknowledge that photographs and/or videos will be taken during the

retreat/immersion.

● I accept that any photographs and/or videos taken during the retreat/immersion may be used on social media or for marketing.

● I certify that I am 18 years or older and have read this document and fully understand it. OR, as a parent or guardian of the participant, I agree to the above for myself and on behalf of the participant.

*(Guardian/Parent to sign if under 18 years of age)

Your Signature

Date