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Wild Heart Writing Retreat

Bacalar, Mexico 2024


We can’t wait to write with you!

We are overjoyed that you have said yes to this creative adventure with us. These community agreements are to hold us in the most nourishing container we can imagine and we can’t wait to be with you.



COMMUNITY AGREEMENTS


For Retreat Participants:


I, ___

_____________________, commit to the following Wild Heart Writing Retreat agreements:


Your experience belongs to you

This community is not here to direct or rescue you nor is it a place for crisis intervention. Writing is a personal and intimate practice and strong feelings are likely to arise. We want to make sure you feel safe and nourished. This container asks you to claim sovereignty over your own experience and prepare the support you need within and beyond the container. 


We share our hearts mindfully

 We avoid the temptation to give unsolicited advice and we ask for consent before offering feedback. We follow the requests by Wild Heart when asked to bear witness without comment. We do not engage in any speech that is hateful, sexual harassment, racist, or any other disrespect to others (including Wild Heart).


Navigating physical space

We respect each person’s boundaries and do our best to heed their requests. We seek ongoing permission for physical touch. We understand that we are humans in tight quarters and that we may need to apologize when we cross boundaries, and offer grace while continuing to hold our boundaries when unintentional ‘bumps’ occur. We invite technology use to be minimal and only in private spaces to cultivate connection within our circle. 


This circle is confidential

We maintain confidentiality regarding people’s identity when sharing anything about our community outside of the space to maintain a circle of deep trust and connection. We hold what others share of their written work in confidence and do not bring up or reference another’s writing without permission, even during the retreat.


Cultivate a Wild Heart

Wild Heart is rooted in numerous mystical practices and concepts. While the Wild Heart Writing Retreat is not focused on spirituality or grief, it is possible the teachers will share from their point of view. Take what resonates and leave the rest. Everything you do in this space is your choice. We invite you to keep an open mind and heart as we explore new ways of being.





If this space doesn't serve you, go in peace


We reserve the right to ask anyone who does not communicate with compassion or follow these agreements to change their behavior, or to leave the event and premises without refund. We understand that this space does not serve everyone and we send anyone on their way who is not fed here.



Signature:


Date: October 3, 2025





SCOPE OF THE PROGRAM AND DISCLAIMER


I understand that Wild Heart is providing a writing retreat that includes invitations for writing, movement, singing, and contemplative practices, and that I retain my choice in all things, including my spiritual beliefs and whether or not to participate in each activity. 


Wild Heart LLC takes no responsibility for the activities of retreat participants while onsite at Rancho Encantado or beyond.


In accordance then, Wild Heart, LLC bears no responsibility for any one who chooses to participate in the Wild Heart Writing Retreat. Your signature releases liability from all teachers named herein: Mirabai Starr, Willow Brook, Adriana Rizzolo, Monika Denise Burkholder, Rosa Santoyo, and Mansoor Fassihi.


I understand that Wild Heart (Mirabai Starr, Willow Brook, Adriana Rizzolo, Monika Denise Burkholder, Rosa Santoyo, and Mansoor Fassihi.) are not providing health care, medical services, or mental health services. I understand that Wild Heart does not provide any diagnostics, treatments, or cures. Any suggestions, advice, or invitations given by the aforementioned individuals or the Wild Heart team are not professional medical advice.


I understand that Wild Heart Writing Retreat is not a grief retreat or providing trauma treatment and that I have the emotional stability for an in-depth writing retreat that may stir up my inner emotional experience.


I understand that Wild Heart welcomes people from all spiritual and religious paths (including none), backgrounds, races, ethnicities, and sexual orientation. I understand that I am not asked to subscribe to any spiritual path, religion, or belief system by participating in Wild Heart’s offerings.


I participate in Wild Heart Writing Retreat in my full sovereignty and choice.


I understand that my registration is final and I will purchase travel insurance with a provider to cover any losses sustained as a result of cancellation, medical issues in the event of an accident or illness. 


ILLNESS and INJURY

I am fully aware of COVID-19 and the risks associated with being around others during this global pandemic. I take responsibility for joining this retreat with the following understanding:

  • I understand and agree that Wild Heart and its facilitators (Mirabai Starr, Willow Brook, Adriana Rizzolo, Monika Denise Burkholder, Rosa Santoyo, and Mansoor Fassihi), are not liable for personal injury, illness, or any other condition or effect (including an injury, illness, accident, condition, or effect that is caused by criminal activity) that results directly or indirectly from my participation in a Wild Heart retreat.
  • I am fully aware that I will be sharing space and/or living together at a retreat center with a group of people in close proximity.
  • I accept that I have choice regarding my own vaccination status, decision to wear a mask or not, and my proximity to others (including my decision to be in a shared room, if applicable).
  • I herby confirm that I will ONLY join this retreat if I have not manifested any symptoms related to COVID-19, that I am COVID-19 negative (to the best of my knowledge), and will wear a mask if I have symptoms of another communicable illness. 
  • I agree that I will wear a mask and isolate myself from others in the case that I contract COVID-19 during the retreat, and will inform the leaders immediately of my status. I understand that Wild Heart has the right to exclude me from events in proximity to others or to ask me to leave the premises immediately. I confirm, that in this situation, I am not eligible for a refund of any kind.
  • I hereby confirm that I assume all responsibility with regards to my health and therefore release Wild Heart from any responsibility regarding my health, COVID-19, or any other illness or injury. 
  • I hereby confirm that I assume all responsibility for the physical risks that I take and understand the possibilities of slips, falls, injuries during Body Temple Movement or general movement throughout the retreat grounds or on field trips. 
  • I hereby agree that in the unlikely case of my unconsciousness, Wild Heart has my permission to seek out emergency help on my behalf, according to their best judgement. I understand any medical or emergency care will be at my expense.


Our team member Mansoor Fassihi will be documenting our gathering. We cherish this opportunity to capture the beauty we will create together.

Optional: I give permission for my image to be used for Wild Heart promotional purposes.


Initials Retreat Participant:___


_________



By submitting my electronic signature below, I, ____

____________________, acknowledge that I have read the above information and agree to all that is asked of me. This includes a release of liability of Wild Heart concerning my welfare. I understand that this retreat is not meant to be mental health treatment or therapy. It is solely meant to help develop the skill of writing.



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First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Parent or Guardian's Email Address
Email*
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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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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