Name *

First Name

Last Name

Date of birth

MM

DD

YYYY

Gender

Male

Female

Other

Prefer not to say

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you regularly hike

Yes 1-5 miles

Yes 5-10 miles

Yes 10+ miles

No

Have you practised Yoga before?

Yes

No

Do you have any health limitations or physical injuries? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma, diabetes, seizures, osteoporosis, etc.)

Yes

No

Women: Are you pregnant or is there any possibility of being pregnant? If Yes, please indicate your due date

MM

DD

YYYY

Would you like to pre-book a massage? (Payments are to be made directly to the masseuse and are not included in your retreat package)

Yes

No

Are you bothered by scents (essential oils, incense, perfumes etc.)? If yes, please let us know the details.

Yes

No

Do you have a preference in your bathroom type? (Preferred option can not be guaranteed)

Bath

Shower

Do you have any special dietary requirements or preferences? (eg: gluten-free (please specify if you are celiac), allergies, vegan etc…)

Yes

No

Emergency Contact

First Name

Last Name

Phone

(###)

###

####

T&C's

AGREEMENT OF RELEASE AND WAIVER OF LIABILITY I hereby agree to the following: As I participate in activities offered by the hosts and special guests, I understand that the offerings of this retreat are not a substitute for medical attention, examination, diagnosis, or treatment. I will receive fitness related information and instruction. I recognise that all exercise programs require physical exertion that may be strenuous and may cause physical injury and I am fully aware of the risks and hazards. If at any time during the activities I feel discomfort or pain, I will inform and seek assistance from the activity. I may rest at any time during the class and over the weekend. I will listen to my body and respect its limits on any given day. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any activity program. I represent and warrant that I am physically fit and I have no medical condition that would prevent my participation in fitness classes or workshops. I recognise that it is my responsibility to notify my instructor of any serious illness or injury before every class, workshop or hike. I accept that neither the instructors, nor the hosting facility, are liable for any injury, or damages, to person or property, resulting from my participation in this retreat. I understand that the 50% deposit for the retreat is final with no refunds and the balance of my payment is due by 19th August, 2025. Cancellation fees will apply due to associated costs such as the catering service, accomodations, special guests, swag etc. I agree that all cancellations made less than two weeks in advance of the retreat be paid in full and that I may transfer my spot to another person. Exclusion of Participation: In the unfortunate circumstance, if a guest conceals physical and/or health issues, is unfit, and/or causes disruptions that endanger the provision of the service and/or the health of other participants, facilitators, or equipment the guest can be excluded from the participation of the Retreat after an initial warning. If the situation arises, the contract will be terminated without further notice, already paid costs are non-refundable and incurring costs are to be paid by the guest. I have read the above release and waiver of liability and fully understand it’s contents as well as the Refund/Cancellation Policies. I voluntarily agree to the terms and conditions stated above.

Tick to confirm