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The Retreat Waiver 

Welcome to The Retreat!
 

As you prepare to join us for an enriching healing experience, please carefully read and complete the following waiver form. This ensures your understanding and agreement to the terms of participation in our in-person sessions.

About You

Please fill out the following form.

Date of birth
How did you hear about us?

About Your General Health

The following questions provide information about your general health. Some of The Retreat activities may push you physically and emotionally, so it is important to be honest in your answers.

Do you have any sensitivity to sound or vibration?
No
Yes
Do you have any difficulty lying on your front or back?
No
Yes
Do you have any metal implants, a pacemaker or body piercings?
No
Yes
Have you been in an accident or hospitalised in the last 2 years?
No
Yes
Have you had surgeryin the last 2 years?
No
Yes
Do you have any dietary requirements?
No
Yes
Do you have any allergies?
No
Yes
Do you take any medications?
No
Yes
Are there any other circumstances that the team should know about?
No
Yes
Do you suffer from any of the following conditions:
Anxiety
Fear
Panic attacks
Low/High blood pressure
Other
Do you use recreational drugs?
No
Yes

Planned Activities

During the retreat a number of activities are pre-planned. Please review the list and let us know if you have concerns about your ability to participate in any of the activities.

Planned activities

The Retreat Planned Inclusions

There are a number of planned inclusions and activities covered by The Retreat. You should have received a copy of your itinerary outlining dates and activities. If you have not received a copy, please let us know.


Included in The Retreat:

  • Accommodation

  • Airport Transfers

  • Food

  • Planned Activities

Personal Responsibilities

Outside of the above planned inclusions, each participant is responsible for organising the following. Please tick each item to notify that you have read and understand your personal responsibilities.

I am responsible for:
I have received the following information emails about The Retreat:

Waiver of Liability

By participating in this Retreat, you acknowledge that you are fully responsible for your own safety and personal liability. The organisers take no responsibility for any injury, illness, or harm that may occur. By ticking this acknowledgement, you agree to waive any claims of liability against the organisers and will not seek legal recourse for any injury or illness arising from your participation.


While we will make every effort to ensure that all activities are conducted safely, you understand and accept that we cannot guarantee that these activities are entirely without risk.

Consent and Acknowledgement

Consent and Acknowledgement

I confirm that the information provided is correct and current to the best of my knowledge. I understand that this information is collected for safety purposes and will be kept strictly confidential unless I provide written consent to share it.


I hereby give my consent to receive treatments/healing and acknowledge that I am participating voluntarily and at my own risk. I am aware of the risks associated with receiving these services and assume full responsibility for my health and safety during and after the sessions.


I agree to release, waive, discharge, and hold harmless the organisers, therapist/healer, and their heirs, executors, administrators, and personal representatives from any and all liability for injuries, damages, or claims relating to or resulting from my participation and receipt of services, now or in the future, whether foreseen or unforeseen.


Consent for Medical/Emergency Care

In the event of a medical emergency, I give my consent for the organisers to arrange emergency medical care on my behalf if necessary. I understand that every effort will be made to contact my emergency contact or next of kin, but should they be unreachable, I authorise the organisers to act in my best interest.


During The Retreat

  • I will immediately inform the therapist/healer/organiser if I experience any pain or discomfort during the session. I acknowledge that any pain or discomfort experienced during or after the session is not the responsibility of the therapist/healer/organiser.


  • I understand that the services provided are not a substitute for medical care, and that the therapist/healer/organiser is not qualified to perform medical examinations, provide diagnoses, or give medical advice.


  • I affirm that I have disclosed all known medical conditions and injuries to the therapist/healer/organiser and agree to inform them of any changes in my health or medical condition.


Delays and Scheduling

I understand that the organisers are not responsible for any delays related to travel or flights and cannot pause or delay planned retreat activities due to such delays. It is my responsibility to ensure timely arrival for all scheduled activities.


Privacy and Confidentiality

  • I consent to my medical information and treatment notes being shared with third-party health practitioners if referred by my therapist/healer/organiser and agreed upon by me.


  • I acknowledge that my personal information may be disclosed by the therapist/healer/organiser if required by law.


Behaviour and Conflict Resolution

Participants are expected to treat each other, the organisers, and all others with respect and courtesy. Should any situation arise that involves conflict or disagreement, it is expected that all participants engage in respectful communication to resolve the matter. The organisers reserve the right to take appropriate action, including removal from the retreat, if participants fail to uphold these standards.


Client Agreement

By checking the box below, I acknowledge that I have read and fully understand the contents of this waiver. I agree to the terms and conditions set forth above and release the organisers, therapist/healer from any and all liability related to my participation in the retreat.

Photo/Video Consent

Please feel free to ask your therapist/healer any questions before, during, or after the session. Your therapist is a skilled professional and is committed to supporting your journey towards healing and wellness.

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