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SHOSHONI WAIVER


I, (Please print name here) ___________________________________________________________, the undersigned, hereby confirm and acknowledge that:

1. I have been advised that the Shoshoni Yoga Retreat and SGRY™ is a non-profit corporation organized under the laws of the State of Colorado, as a spiritual retreat center, whose Retreat and/or Rejuvenation Program involve the utilization of experiential techniques including hatha yoga techniques, meditation practices, and health therapies. I further understand that when I use the facilities of Shoshoni Yoga Retreat, I do so as a member of the ShambhavAnanda Yoga™ spiritual community for the time that I am on the premises and engaged in the activities that are part of its spiritual tradition.

2. I understand and acknowledge that participation in the Retreats or Programs may involve physical activities that carry inherent risks. I have been specifically advised that such activities may trigger physical issues related to my known or unknown health conditions or vulnerabilities. I further acknowledge that the high-altitude environment in which the Retreats or Programs take place may adversely affect the body, potentially intensifying fatigue, shortness of breath, dizziness, or other physiological effects, particularly for individuals with underlying medical concerns.

3. I have been made aware that, during the course of the above-mentioned Retreat or Program, certain physiological responses may arise, particularly in connection with the release of anger, resentment, or other deep emotional states. I willingly choose to participate with full awareness of the potential risks and consequences mentioned above.

4. I agree to hold the Shoshoni Yoga Retreat and its staff free and harmless for and from any claims, demands, and suits for damages from any personal injury or complications whatever that may result from such Retreats and Programs, except to the extent caused by the gross negligence or willful misconduct of Shoshoni Yoga Retreat and I specifically waive any right I may have thereto.

5. I acknowledge that individuals participating in the Center’s work study program are volunteers and are not employees, agents, or official representatives of Shoshoni Yoga Retreat. I understand that their views, opinions, and personal expressions—whether verbal, written, or otherwise conveyed—do not necessarily reflect the values, policies, or official positions of Shoshoni Yoga Retreat. I further recognize that the Center is not responsible for any statements or conduct by work study volunteers that fall outside the scope of authorized programming or instruction.

6. I acknowledge that no guarantees, warranties, or assurances have been provided regarding the results or outcomes of my participation in the Retreats or Programs. I further understand that such participation may involve physical activities or emotional processes capable of eliciting physiological responses, which may subject my body to a risk of harm. I voluntarily and knowingly assume all such risks associated with my participation.

7. I, the undersigned, having been fully informed of the hazards and possible consequences involved in the Retreats and Programs set forth above and activities or experiences associated therewith by means of the practices and methods explained to me, nevertheless hereby consent to the use of and my participation in all of the practices and methods associated with these Retreats and Programs. I agree to hold the Shoshoni Yoga Retreat free and harmless for and from any claims, demands, and suits for damages from any personal injury or complications whatever that may result from such Retreats and Programs and I specifically waive any right I may have thereto.

8. I agree to exercise reasonable care while on the premises of the Shoshoni Yoga Retreat. If I cause damage through intentional, reckless, or grossly negligent conduct I understand that I may be held responsible and I agree to cover the reasonable costs of repair or replacement. I acknowledge that there may be a fee of at least $100 for damage to carpet or furniture. 

9. I agree to support Shoshoni Yoga Retreat’s goal of fostering a safe, respectful, and inclusive environment for all individuals. If I witness or become aware of any conduct by staff, participants, visitors, or volunteers that is unlawful, disruptive, discriminatory, or otherwise inappropriate, I will promptly notify Shoshoni Yoga Retreat staff (“Management”). I acknowledge that all reports will be handled with discretion and in alignment with Shoshoni Yoga Retreat’s values and procedures.

10. I, the undersigned, acknowledge that Shoshoni Yoga Retreat reserves the right to refuse service to anyone, and to request any guest, participant, or volunteer to leave the premises at any time, with or without prior notice, if Management determines that the individual has engaged in disruptive, unsafe, or inappropriate behavior, failed to comply with Retreat policies or instructions, or poses a risk to the safety, well-being, or experience of others. No refunds shall be provided in such cases.

11. By participating in Online Programs offered by Shoshoni Yoga Retreat, I acknowledge and voluntarily assume all risks associated with physical activity and breathwork practices, including but not limited to the potential for physical, emotional, or psychological injury. I acknowledge that the instructors are not providing medical advice and agree to consult a healthcare provider before beginning any new exercise program. In consideration of your participation, you release, waive, and discharge Shoshoni Yoga Retreat, S.G.R.Y., its instructors, employees, and agents from any and all liability, claims, demands, or causes of action arising from your involvement in these classes, including injuries, damages, or losses. I agree to indemnify and hold harmless Shoshoni Yoga Retreat and S.G.R.Y. from any related claims or expenses. Your participation confirms that you have read, understood, and agreed to this waiver of liability.

12. Colorado Wildlife Guidelines. I agree to abide by Colorado wildlife guidelines for the safety of Shoshoni guests, residents, and staff. I acknowledge that, according to Colorado law, individuals are required to stay at least 25 yards (75 feet) away from moose and elk in national parks and 100 yards away from other big game animals. This is required at Shoshoni Yoga Retreat as well. Violations could result in being asked to leave Shoshoni Yoga Retreat and its grounds.

13. Photo & Media. I agree to grant S.G.R.Y., Shoshoni Yoga Retreat, and its agents and affiliates the right to use, edit, and display any photographs, videos, or other media featuring the participant for promotional, advertising, and other business purposes in any format without requiring further approval or compensation. The participant waives any right to royalties, claims, or ownership interests in the content, but may request the removal of their photo by submitting a written request. I further agree to release above mentioned parties from any claims related to the use of their image.

I certify that I have read and fully understand or have had explained to me the above waiver, and that it is my intention to participate in the above Retreat and/or Program.

 

____________________________________________________________________________

Signature of Participant or Person with authority to Consent for Participant                Date


_____________________________________________________________________________

Witness to Signature

First Participant's Name
First Name*
Last Name*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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