Embodied Elements Retreat
By sending your deposit, you are agreeing to the retreat's terms and conditions as listed below.
You will receive a .pdf version to review, sign, and return as part of your confirmation process.
TERMS & CONDITIONS
_______ I acknowledge that my $500 deposit is non-refundable.
_______ I acknowledge that the remaining balance is due by 05/05/2023 and I agree to fulfill the payment in its entirety. In the event that I fail to complete the remaining balance by this date, I accept that this agreement is canceled and I have forfeited any preceding payments.
_______ I acknowledge that if I choose to cancel for any reason, I must do so in writing to: firstname.lastname@example.org by May 5, 2023.
_______ I acknowledge that if I choose to cancel, I have forfeited the $500 deposit.
_______ I acknowledge that a full refund (minus the $500 deposit) will be upheld if I cancel in writing prior to May 5, 2023. Any cancelation request after May 5, 2023 will not receive a refund of any amount regardless of the cancelation reason.
_______ I acknowledge that there will be no refunds for any reason for any person who attends the retreat in full or in part.
_______ I acknowledge that I have been advised that travel insurance is STRONGLY recommended and in the event that I choose to employ travel insurance, it is at my own expense.
_______ I acknowledge that cancelations due to Covid-19 are not available unless designated by the venue.
_______ I acknowledge that neither the organizer (Consciously Christina) nor the retreat center (Casa Om Potomac LLC) are responsible for lost, stolen, or damaged items.
_______ I acknowledge that I am responsible for my travel expenses (airfare, land travel, insurance).
_______ I acknowledge that I am willing to participate in yoga, movement, breath, and meditative practices at the risk of injury and assume sole responsibility.
_______ I acknowledge that my personal safety throughout the entirety of the retreat is ultimately my responsibility.
_______ I acknowledge that I agree to fully comply with ALL mandated Covid-19 regulations of The United States of America, West Virginia, and Casa Om Potomac's guidelines including but not limited to: providing a negative Covid-19 result within 36 hours (if explicitly required for entrance to venue), all other mandated regulations such as mask-wearing, hand-washing, and social distancing made expressly clear during the current period of retreat travel (June 15-18, 2023).
_______ I acknowledge that I will be informed of how/where to acquire a Covid-19 test prior to departure from the retreat and I accept that it is at my expense (should one be required for re-entry into a country other than The United States of America).
WAIVER AND RELEASE OF LIABILITY
Consciously Christina, the teacher on hand (referred to herein as the “trainer”) and the undersigned client (referred to herein as the “client”), hereby agree to the following terms and conditions regarding client’s use with Consciously Christina and Casa Om Potomac LLC.
In consideration of the risk of injury while participating in the activity of “Embodied Elements Retreat 2023”, and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Consciously Christina and Casa Om Potomac LLC and their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY.
I agree to indemnify and hold harmless Consciously Christina and Casa Om Potomac LLC against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Consciously Christina and Casa Om Potomac LLC incur any of these types of expenses, I agree to reimburse the appropriate party. I acknowledge that Consciously Christina and Casa Om Potomac and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Consciously Christina and Casa Om Potomac LLC. I ACKNOWLEDGE THAT THIS ACTIVITY MAY INVOLVE A TEST OF A PERSON'S PHYSICAL AND MENTAL LIMITS AND MAY CARRY WITH IT THE POTENTIAL FOR DEATH, SERIOUS INJURY, AND PROPERTY LOSS. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event.
I agree to be familiar with and recognize the danger and risk of injury to person and or property which may result from the use of facilities, including without limitation, injury from slipping and falling, excess fatigue or stress, muscle strain, COVID-19, or any other unforeseen cause. With full knowledge and understanding of such risks, I agree to use the facilities of Casa Om Potomac and the Consciously Christina's services rendered at my own risk and I PERSONALLY ASSUME THE RISK for any harm, injury, or damage that may occur as a result from use of Casa Om Potomac's facilities. I hereby fully and forever RELEASE, RELINQUISH, ACQUIT, AND DISCHARGE Consciously Christina and Casa Om Potomac LLC (collectively, “Released Parties”), from any and all claims, demands, actions, causes of action and rights (whether known, unknown, contingent, accrued, inchoate, or otherwise) which client may have against Consciously Christina or other Released Parties arising out of or relating to Consciously Christina or Casa Om Potomac's passive or active negligence. I expressly warrant and represent and hereby state and represent that no promise or agreement which is not herein expressed has been made to me in executing this Release and Waiver of Liability and that I am not relying upon any statement or any representation of any of the Released Parties.
I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Consciously Christina AND Casa Om Potomac LLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Consciously Christina AND Casa Om Potomac LLC FOR PERSONAL INJURY OR PROPERTY DAMAGE. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Consciously Christina and Casa Om Potomac LLC, its agents, and employees. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.
I understand that while working with Consciously Christina, my image (including live or recorded video images) may be used or shown on the Consciously Christina website or social media outlets (Instagram, YouTube, etc.), and that by signing this waiver form I consent to the use of these images.