Retreat Liability Form

Zen Goddess Retreat Liability Waiver Form
Participant Information
Full Legal Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Info
Emergency Contact Info

First NameLast Name
Relationship
Emergency Contact Info
example@example.com
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Health & Participation Acknowledgment
YesNo
If yes to previous question please provide details. If not, skip to next question.
YesNo
If yes to previous question please provide details. If not, skip to next question.
YesNo

Waiver Agreement

I understand that retreat activities involve inherent risks.

I confirm I am voluntarily participating.

I understand Zen Goddess LLC does not provide medical advice.

I release Zen Goddess LLC from liability to the fullest extent permitted by law.

I acknowledge the refund policy.

I understand a liability waiver is required as part of booking confirmation.
Yes, I consent to photography/video
Signature

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Date Signed

MonthDayYear
Date
Full Legal Name

First NameLast Name
By signing this agreement, you are entering a sacred space of transformation, self-discovery, and elevated wellness. Zen Goddess Retreats are designed to support you, but your journey is ultimately your own.
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Zen Goddess Retreat Liability Waiver Form