Retreat Liability Waiver

Please read the following waiver carefully before participating in any activities at [Retreat Company Name]. By signing this waiver, you agree to the terms and conditions outlined below.

Participant Name:

First Name

Middle Name

Last Name

Date of Birth

Participant Address:

Participant Email:

Participant Phone Number:

Assumption of Risk

By participating in retreat activities, you acknowledge that such activities may involve inherent risks, including but not limited to physical injury, emotional distress, and unforeseen events. You voluntarily assume all risks and responsibility for any injuries or damages you may incur.

Release of Liability

You agree to release, discharge, and hold harmless [Retreat Company Name], its employees, facilitators, and agents from any and all liability, claims, demands, or actions arising from injury, harm, or death during your participation, including those arising from negligence.

I agree to the assumption of risk and release of liability

Code of Conduct and Safety

By signing this waiver, you agree to follow all rules, regulations, and instructions provided by [Retreat Company Name]. Failure to comply with these rules may result in removal from the retreat without refund.</p>

I agree to follow all retreat rules and instructions

Medical and Mental Health Clearance

You confirm that you are in good physical and mental health, and that it is your responsibility to consult a physician or mental health professional before participating if necessary.

I confirm that I am in good health and fit to participate

Indemnification

You agree to indemnify and hold harmless [Retreat Company Name], its employees, facilitators, agents, and representatives from any claims, actions, damages, or liabilities arising from your participation in retreat activities.

I agree to indemnify [Retreat Company Name]

Are you signing on behalf of a minor? Please add them to the form

Date:

Emergency Contact:

Participant’s Signature: