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BLUE JASMIN YOGA RETREAT

KOH SAMUI ~ THAILAND

VIKASA II ~ Yoga & Jiu Jitsu Retreat

May 18th - May 24th, 2025

Liability Waiver + Retreat Agreement

 




Liability Waiver

Facilitators:

  • Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation
  • Level Up Brazilian Jiu Jitsu Corporation

Retreat Dates:

  • May 18th-24th, 2025

Location:

  • Vikasa Yoga Retreat & Life Cafe in Koh Samui, Thailand

Release and Waiver of Liability: In consideration of your participation, you agree to release, waive, discharge, and hold harmless Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation, Level Up Brazilian Jiu Jitsu Corporation, and their officers, employees, agents, and representatives from any claims, damages, or losses arising from your participation in the retreat, except in cases of gross negligence or willful misconduct. This waiver applies to all activities, including yoga, jiu jitsu, excursions and travel.

Assumption of Risk: Participants must assume the risks inherent in travel and sport activities. Our retreats take place in remote locations with limited medical services. You acknowledge these risks and assume full responsibility for any personal injury, illness, death, or loss of property.

Medical Insurance and Emergency Treatment: I am responsible for my own medical insurance and hereby consent to receive emergency treatment which may be necessary due to the event of injury, accident, or illness during the retreat. I understand that any resulting expenses will be my responsibility.

Governing Law: This waiver is governed by the laws of the State of California, USA, and any disputes will be resolved under California law.

Emergency Contact Information: Participants must provide emergency contact information and any known allergies or medical conditions that may require attention during the retreat.

Prohibited Behavior: In the case someone is acting violently, the organizers hold the right to refuse service immediately and in the future, and they will be removed from the premises.

By signing this waiver, you acknowledge that you have read, understood, and agree to the terms and conditions outlined here.

Participant's Signature:

Date: November 15, 2024

___________________________________________________________________________________________________

Thailand Retreat Agreement

Facilitators:

  • Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation
  • Level Up Brazilian Jiu Jitsu Corporation

Retreat Dates:

  • May 18th-24th, 2025

Location:

  • Vikasa Yoga Retreat & Life Cafe in Koh Samui, Thailand

1. Reservation and Payment Terms: To reserve your place on one of our destination retreats, please complete the registration form and submit it with payment as follows:

  • A non-refundable deposit of $500 is required upon registration.
  • A second payment of $750 is due by December 1, 2024. If this payment is made after this date, a $75 late fee will apply.
  • The final payment is due by March 1, 2025. If the balance is not paid on or before this date, we reserve the right to cancel your reservation in accordance with Section 4 below, and a $75 late fee will apply.

2. Your Obligations: We require the following items from you to confirm your reservation. Failure to provide all of the following items subjects your reservation to cancellation.

  • Payment:
  • Deposit: A non-refundable deposit of $500 is required upon registration.
  • Second Payment: A second payment of $750 is due by December 1, 2024. If this payment is made after this date, a $75 late fee will apply.
  • Final Payment: The total retreat price is due by March 1, 2025. If the balance is not paid on or before this date, we reserve the right to cancel your reservation, and a $75 late fee will apply.
  • Personal Information: Provide all necessary details, including but not limited to your full name as listed on your passport and any pre-existing medical conditions that may affect your ability to participate fully in the destination yoga retreat.
  • Health and Fitness: You promise you are in good physical and mental health and at a level appropriate to participate in the destination retreat you have selected. Any health concerns must be discussed with a health professional before the departure date. You are advised that our retreats often take place in remote areas with limited access to traditional medical services. Any medical or evacuation expenses are your sole responsibility, and we strongly encourage you to purchase travel insurance. We reserve the right to refuse participation based on medical, fitness, or other grounds.
  • Passport, Visa, and Related Items: You are responsible for obtaining and maintaining a valid passport and all appropriate visas, permits, and certificates. Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation and Level Up Brazilian Jiu Jitsu Corporation are not responsible if you are denied entry or exit due to a lack of correct documentation.
  • Travel Insurance: Proof of travel insurance is required to join this retreat. You are solely responsible for ensuring adequate insurance coverage for the full duration of the retreat. You will be solely responsible for any loss related to your failure to procure proper travel insurance.

3. Our Obligations: Upon confirmation of your booking, we will reserve all accommodations, including meals, yoga and jiu jitsu classes on your behalf.

  • Trip Inclusions:
  • Room with A/C, a private bathroom, and a safety box at Vikasa.
  • Yoga (Kundalini/Ashtanga/Vinyasa) & AcroYoga Classes.
  • Meditation + Chanting + Pranayama + Sound Healing
  • Breakfast Buffet at Vikasa Life Cafe.
  • Dinner Buffet at Vikasa Life Cafe.
  • Thai Massage (1 hour).
  • Temple Tour Excursion.
  • Elephant Sanctuary Excursion.
  • Boat Adventure to the Angthong National Marine Park.
  • Intro to Muay Thai Class.
  • Attend a Muay Thai Stadium Fight.
  • Transport from Koh Samui Airport (USM) to the retreat on May 18, 2025.
  • Special gifts from your retreat hosts!
  • Exclusions:
  • Airfare.
  • Lunches.
  • Drinks & snacks.
  • Travel insurance. (required)
  • Alcoholic beverages.
  • Gratuities.
  • Transport to the airport after the retreat.
  • Changes, Postponement, Cancellation, or Delay: We reserve the right to make changes to any aspect of the retreat if necessary due to hazardous or adverse conditions, or if an act or omission of a third party prevents the retreat. If an instructor cannot lead the retreat, we will substitute another instructor at our discretion. Changes may be made to the itinerary without prior notice due to local circumstances or events beyond our control.
  • Effect of Changes, Postponement, Cancellation, or Delay: In such cases, no refunds will be provided, and we are not liable for any additional costs incurred.

4. Cancellations: All deposits are non-refundable for any reason. Aside from your $500 deposit, your remaining payments are 100% refundable if you cancel at least 60 days before the retreat start date. If less than 60 days before the start date, all payments are non-refundable. The last day to cancel and receive a refund (excluding the non-refundable deposit) is March 15, 2025. Notification must be sent via email with your signature and date.

5. Force Majeure: If we are prevented from performing any obligations under this agreement by reasons beyond our control, we are under no liability and may cancel the retreat or take other actions as specified.

6. Limitation of Liability: The aggregate liability of the Organizers for any claim shall not exceed the amount paid for the retreat.

7. Indemnification: You agree to indemnify, defend, and hold harmless the Organizers from any claims, damages, liabilities, and expenses (including reasonable attorneys' fees) arising out of or related to your actions during the retreat.

8. Arbitration Clause: Any disputes arising out of or relating to this agreement will be resolved through binding arbitration in accordance with the rules in Los Angeles County.

9. Electronic Signature Clause: Your electronic signature on this agreement will be considered as effective as an original signature and will be binding for all purposes of this agreement.

10. Governing Law: This agreement is governed by the laws of the State of California, USA, and any disputes will be resolved under California law.

Photos and Video Release: By participating, you grant permission to use your image, likeness, and voice in photos, videos, and other promotional materials without compensation.

No Drug Use: There is absolutely no drug use permitted on the retreat. If found using drugs, you will be removed from the premises immediately.

Emergency Contact Information: Participants must provide emergency contact information and any known allergies or medical conditions that may require attention during the retreat.

Prohibited Behavior: In the case someone is acting violently, the organizers hold the right to refuse service immediately and in the future, and they will be removed from the premises.

By signing this agreement, you acknowledge that you have read, understood, and agree to the terms and conditions outlined here.

Participant Signature:

I have read and agree to the terms and conditions of this agreement.

Participant Signature: 

Date: November 15, 2024

Parent or Guardian's Email Address

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Eighth Participant's Name

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Tenth Participant's Signature*
Food Allergies

Please list your any food allergies or sensitivities you have here: *
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Room Options
Which room would you like for your retreat experience?*
Prana Cabana (Single Occupancy)
Prana Cabana (Double Occupancy)
Prana Cabana Plus (Single Occupancy)
Prana Cabana Plus (Double Occupancy)
Lotus Pad (Single Occupancy)
Lotus Pad (Double Occupancy)
Lotus Pad Plus (Single Occupancy)
Lotus Pad Plus (Double Occupancy)
Room Sharing

If you are sharing a room with someone, please write in their name above. If you are having your own room, please write in 'solo'
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Passport Info

Passport Number & Expiration Date *

What is your nationality? *
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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