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Kāla Yoga LLC
Liability Waiver Agreement 

*the entirety of the following is subject to change as needed:


Date(s): May 19-25, 2025

Location: Shambala Private Game Reserve, South Africa 

Offering: 2025 Luxury Safari Retreat Week

Host: Michaela (Kala) MacDonald, "Yoga with Kala”, Kāla Yoga LLC

Deposit: $1000 USD per person

 

I (Participant) hereby understand and agree to the following: 

I recognize that there are many risks of injury, damage, or harm inherent in my participation in the Offering, led by the Host and that it is not possible to specifically list each and every individual risk. These risks may include, and are not limited to: (a) risks, dangers and hazards inherent in engaging in Yoga and/or meditation; (b) risks and dangers caused by the negligence or willful acts of the owners, employees, officers or agents of the Location facilities, or any guides other than the Host (who are not affiliated with the Host), or by other participants participating in the Offering; (c) risks inherent in traveling to a foreign country – e.g., war, terrorist attacks, communicable disease, muggings; and (d) natural dangers, such as tornadoes, earthquakes, or other natural disasters.


I hereby expressly assume any and all risks (including but not limited to the foregoing risks) in attending and participating in the Offering. In exchange for the opportunity to participate in and attend the Offering, I hereby release, waive, discharge and covenant not to sue the Instructor and release the Host from any and all liability, claims, demands, actions and damage, or injury, including death, that may be sustained by me while participating in the Offering.


I have had an opportunity to ask questions and obtain information regarding the Offering to my satisfaction. I subjectively understand the risks of my participation in the Offering, and knowing and appreciating these risks, I voluntarily choose to participate, assuming all risks due to my participation. I acknowledge and agree that the Host is not responsible for providing any security while attending the Offering, and that I have conducted satisfactory due diligence into Location and surroundings where the Offering is to be held, and any lodging, hotel facilities, or otherwise there.


1.) RISK OF INJURY - That I am participating in the Offering during which I will receive information and instruction regarding, but not limited to, yoga, pranayama, breath work, personal training and functional mobility. I recognize that yoga requires physical exertion that may be strenuous and may cause physical injury, including serious injury, disability, and even death, and I am fully aware of the risks and hazards involved. In further consideration of the Offering, I knowingly, voluntarily and expressly waive any claim I may have against the Host for any injuries or damages, known or unknown, including serious injury, disability, and even death, that I might incur as a result of participating in any activities, scheduled or unscheduled as part of the Offering, while participating in the Offering. (i.e. excursions, helicopter ride(s), ATV/quad bike usage, animal encounters, tours, etc.) 

2.) MEDICAL CONDITIONS - I understand that it is my responsibility to consult with a physician prior to and regarding my travel to and participation in the Offering. I represent and warrant that I am physically fit and I have no medical conditions that prevent my full participation in the Offering.

3.) PREGNANCY - 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 the Offering. I assert that I am of fit health to participate in the Offering and will alert the Host that I am pregnant prior to participation in the Offering.

4.) RESPONSIBILITY - In consideration of being permitted to participate in the Offering, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, including serious injury, disability, and even death, which I might incur as a result of participating in the Offering.

In further consideration of being permitted to participate in the Offering, I knowingly, voluntarily and expressly waive any claim I may have against the Host for injury or damages that I may sustain as a result of participating in the Offering. I, my heirs and legal representatives forever release, waive, discharge and covenant not to sue the Instructors for any injury or death caused by their negligence or other acts during the Offering.

5.) MEDICAL EXPENSES - Should the participant receive any medical treatment that is deemed necessary, with or without the consent of the Participant, the Participant understands and agrees that they are solely responsible for any costs related to the medical treatment, transportation, and anything else that may result in a fee.

6.) PAYMENTS - I clearly understand that as a Participant of the Offering, my Deposit is NONREFUNDABLE and that the full payment/rate for the Offering is due in full no later than the advertised date to guarantee my spot, and that all payment(s) toward the total balance of the Offering are also NONREFUNDABLE. All payment(s) for this event are to be paid directly to the Host in U.S. currency (USD).

7.) PHOTO VIDEO RELEASE - I agree to give The Host permission to use photos/ video of the Participant taken at the Offering for any promotional materials, both printed and digital. I understand that no compensation will be extended for any such use, which may include the Participant’s name and likeness. Use of the resulting photos/video of the Participant taken at the Offering may be perpetual, worldwide, and/ or non-revocable at the sole discretion of the Instructor. The participant waives any potential claims for defamation.

8.) SEVERABILITY CLAUSE - If this waiver, or any part of the waiver, is not effective for any reason, I, my heirs and legal representatives forever release, waive, discharge and covenant not to sue the Instructors for any injury or death caused by their negligence or other acts during the the Offering.

9.) GOVERNING LAW PROVISION - This release in its entirety is intended to be as broad and inclusive as permitted by law.

10.) INDEMNIFICATION CLAUSE - I agree to indemnify and hold harmless the Host against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me, the Participant, or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me, the Participant, or by anyone else acting on my behalf. If the Host incurs any of these types of expenses, I agree to reimburse the Host.

I have read and fully understand and agree to all of the above terms of this Liability Waiver and Release. I am signing this agreement voluntarily and of sound mind. I recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Today's date: November 22, 2024



First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
First Participant's Signature*
Second Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Third Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Fourth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Fifth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Sixth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Seventh Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Eighth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Ninth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Tenth Participant's Name

First Name*

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

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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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*
Parent or Guardian's Information

General Questionnaire:


1.) How long have you been practicing yoga/what kind of yoga do you practice, if any? Feel free to share any initial questions/concerns with the yoga portion of the retreat offering. **note bringing a yoga mat is OPTIONAL, some are available on site or you're welcome to use a provided towel.

3.) Do you have any injuries or other medical conditions that might affect your yoga practice/sessions/participation in safari excursions?

5.) Please disclose any dietary restrictions/allergies/preferences so they can be shared with the chefs. If none write N/A. *
2.) Are you interested in the following Premium excursions/offerings, which are available for an additional fee?
Shooting Range
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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