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Please sign this waiver for the Costa Rica Retreat.

I  hereby agree to the following:

 1  That I am participating in the Yoga  Retreat offered by Koha Yoga, LLC & Abundelicious, llc, during which I will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.

 

2.  I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Yoga/Surf/PaddleSurfRetreat.  I represent and warrant that I am physically fit and I have no medical conditions that would prevent my full participation in the Yoga/Surf Retreat

 

3.  I understand that if I am pregnant, I will take necessary steps to ensure my doctor and health care providers know I am participating in this Yoga Retreat.  I assert that I am of fit health to participate in the Yoga Retreat and will alert all Yoga Teachers whose sessions I participate in that I am pregnant.

 

4.  In consideration of being permitted to participate in the Yoga Retreat,  I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the retreat, including any and all activities done with the Yoga Retreat group, or as an individualat AguaVida Resort.

 

5  In further consideration of being permitted to participate in the Yoga Retreat, I knowingly, voluntarily and expressly waive any claim I may have Koha Yoga, LLC, AguaVida Surf, and Whakapaingia and Sara Laimon Luke and its staff for injury or damages that I may sustain as a result of participating in the retreat

I, my heirs and legal representatives forever release, waive, discharge and covenant not to sue Koha Yoga, LLC and Abundelicious, llc its staff, Whakapainiga and Sara Laimon  and Sarah Phillip its staff for any injury or death caused by their negligence or other acts.

 

6.CANCELLATION POLICY:  I understand that $250 of the registration fee is non refundable.

Further, should participant cancellation occur within 25 days of the event for any reason.

I forfeit all fees.  Should participant  cancellation occur within 50 days of the event for whatever reason, only 50% of the total fee is refundable, less the $500 registration fee.

Should the event be canceled by Koha Yoga, LLC, all fees will be refunded back to participant.

 

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree and confirm being invited to consult legal counsel before signing below.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's 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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's 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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