Retreat Registration Form

Guest Information

Name

First NameLast Name

Email (Please double check spelling)

example@example.com

Birthdate

Date

Gender

MaleFemaleOther

Cell Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Information

Emergency Contact's Name

First NameLast Name

Phone Number

Area CodePhone Number

Have you practiced yoga before?

If YES, what type of yoga have you practiced?

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.)

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

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

How did you learn about this retreat?

On this retreat, I will lead an educational yoga workshop. What topics are you interested in learning more about in order to expand your yoga practice? (i.e. : philosophy, meditation, breath work, mindfulness, movement practices)

What inspired you to come to this retreat?

TERMS & CONDITIONS

Please carefully read the terms in the conditions of this contract. In completing and submitting this, you agree to be bound by these conditions, which constitute the agreement between Lauren Ikeda Yoga LLC. and you.

1. Reservation: This retreat is for adults 18 years of age or older. The total cost for this retreat varies based on accommodation selection.

2. Payment: Payment can be made by cash, check, credit card, Venmo, or via website. Final balances are at minimum due 90 days before the departure date of the retreat. Please refer to the website for the final amount due to Lauren Ikeda Yoga LLC by the required time. Should you not meet these requirements, we will assume that you will not be participating on the trip and cancellation charges in accordance with condition 3 will apply.

3. Cancellations/Refunds: If you wish to cancel your retreat you must notify Lauren Ikeda Yoga LLC. in writing. Once your notice is received, cancellation will take effect subject to the following: All deposits are non-refundable and non-transferrable. If cancellation takes place before the final balance due date of your trip, any payments made will be refunded minus your deposit. Please refer to the website for the refund deadline. If cancellation takes place after the final balance due date, 100% of the retreat price will be forfeited. Payments are nontransferable. Any amount forfeited, which has not then been paid to Lauren Ikeda Yoga LLC. by you, will be recovered from you by Lauren Ikeda Yoga LLC. as a debt due and payable. Lauren Ikeda Yoga LLC. reserves the right in its absolute discretion to refuse a participant the right to participate on a retreat for any reason. If the participant arrives late to the retreat or leaves prior to it's conclusion, refunds will not be made for any unused portion of the retreat. No refunds will be made for meals, yoga classes or other activities that the participant misses or decides not to participate in for any reason.

4. Health and Fitness Requirements: You must be in good physical and mental health to participate on the retreats. My retreats often take place in remote areas with little access to medical services or hospital facilities for serious problems. Medical and evacuation expenses will be your responsibility which is why I strongly encourage you to purchase travel insurance.

5. Cancellation due to Retreat Booking Numbers: Lauren Ikeda Yoga LLC. reserves the right to cancel any retreat prior to departure in the event that there are too few people booked in which case you will be given a full refund of any and all payments made to Lauren Ikeda Yoga LLC. You will not be entitled to claim any additional amounts or seek any compensation for any injury, loss, expenses or damage (either direct or consequential) or for any loss of time or inconvenience which may result from such cancellation (including but not limited to visa, passport and vaccination charges, or departure, gear purchases, airport and airline taxes) so be sure you have travel insurance!

6. Changes, Postponement, Cancellation or Delay: Lauren Ikeda Yoga LLC. reserves the right to make changes to any aspect of the retreat if, in the absolute discretion of Lauren Ikeda Yoga LLC., it is necessary to do so due to conditions that are likely to be hazardous or dangerous or due to any other adverse or threatening conditions whether political or military or terrorist or otherwise or if an act of omission of a third party prevents the retreat or the aspect of the retreat being undertaken in accordance with your booking or for any other reason considered necessary by Lauren Ikeda Yoga LLC. In the event of any change, modification, cancellation postponement or delay under this condition, you acknowledge that you will have no right of refund of the retreat price (whether in whole or in part) and no right to claim compensation for any injury, loss or damage or other additional expenses incurred by virtue of the change, modification, cancellation postponement or delay. Lauren Ikeda Yoga LLC. also reserves, in its absolute discretion, the right to cancel any retreat due to any government travel warning or advice, or any change in such warning or advice. In this event, we will do all we can to transfer any payments made to a future retreat with Lauren Ikeda Yoga LLC. If this is not possible, travel insurance may compensate you depending on the circumstances.

7. Insurance: I strongly recommend the purchase of travel insurance and it is your responsibility to ensure that you are adequately insured for the full duration of the retreat in respect of illness, injury, death, loss of baggage and personal items and cancellation and curtailment.

8. Photographs / Video: The yoga retreat center and/or Lauren Ikeda Yoga LLC. (including assistants) may be photographing and digitally recording parts of the retreat and reserves the right to use any such photographs/videos/digital recordings in its advertising, displays, publicity materials and publications without obtaining further consent from any participant. The undersigned hereby grants the yoga retreat center and/or Lauren Ikeda Yoga LLC. permission to use their likeness in written publications and documentation, and on audio, video, television and the internet. By signing this agreement, you release, discharge and agree to hold harmless the yoga retreat center and/or Lauren Ikeda Yoga LLC. from any liability that may occur in the reproduction of the finished product. All profits, proceeds and income resulting from the production, distribution, sale and promotion of this product are the exclusive property of the yoga retreat center and/or Lauren Ikeda Yoga LLC.

9. Force Majeure: If Lauren Ikeda Yoga LLC. is prevented (directly or indirectly) from performing any of its obligations under this agreement by reason of act of God, strikes, trade disputes, fire, breakdowns, interruption of transport, government or political action, acts of war or terrorism, acts or omissions of a third party or for any other cause whatsoever outside Lauren Ikeda Yoga LLC’s reasonable control, Lauren Ikeda Yoga LLC. will be under no liability whatsoever to you and may, at its option, by written notice to you either cancel the retreat or take any other action as specified in condition.

10. Assumption of Risk: You acknowledge that: by the very nature of adventure travel, they are more challenging and demanding with a commensurately higher level of risk compared with conventional vacations, and involve potential exposure to injury and in the countries and regions in which adventure travel is undertaken, standards of accommodation, transport, health care, hygiene, safety and service provision generally are often not as high as those standards in your country of residence and may require flexibility and patience on your part; and operational control of the retreat may be in the hands of a third party and that your right of action in regard to any shortcomings of that third party’s performance is against the third party and not against Lauren Ikeda Yoga LLC.; and the enjoyment and excitement of adventure travel is derived in part from the inherent dangers and risks associated with adventure travel and that those inherent dangers and risks are a reason why you wish to undertake the adventure retreat.

11. Lauren Ikeda Yoga LLC. Release and Hold Harmless: In consideration of Lauren Ikeda Yoga LLC. accepting your reservation, the undersigned, to the maximum extent permitted by law does hereby release, waive, discharge, hold harmless and agree to indemnify Lauren Ikeda Yoga LLC. and its officers, employees, agents, licensees, guides and other representatives (called “Indemnified Parties”) from any and all claims, damages, actions or losses for bodily injury, property damage, wrongful death, loss of services, lost profits, lost earnings, consequential, exemplary, direct, indirect or punitive damages or otherwise which may arise out of or occur during the undersigned’s travel and/or staying over, in connection with the trip, the retreat, or any activities conducted in conjunction therewith, unless caused by the gross negligence or willful misconduct of the Indemnified Parties; and regardless of the situation or circumstances giving rise to the claim the undersigned does hereby permanently waive any claims he or she has, or may at any time have, against the Indemnified Parties and the undersigned agrees, by accepting the additional inherent dangers and risks associated with travel and the retreat, not to make any claim against or seek any compensation from the Indemnified Parties in respect of any personal injury, illness, or death suffered by you or damage to or loss of property sustained by you as a result of your participation in the trip or the retreat.

The undersigned has been advised and urged to obtain travel insurance to cover against loss resulting from trip cancellation or interruption, weather, natural disaster, strike, illness, job reasons, accident, sickness, evacuation, pre-existing medical conditions, baggage delay, loss, theft, and other losses associated with travel. The undersigned acknowledges that whether or not he/she elects to purchase or not purchase travel insurance, he/she will not look to any of the Indemnified Parties for reimbursement for any loss suffered or occurring during the undersigned’s travel and/or staying over.

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 recognize 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 teacher. 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 recognize that it is my responsibility to notify my teacher of any serious illness or injury before every class. 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 reatreat.

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 terms & conditions as well as the 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.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature