Christ Light Yoga Winter Solstice Retreat - 22-25 June

Important Personal Information Required before coming on the retreat

HEALTH RELATED INFORMATION

If there is anything that I need to be aware of with respect to your physical, mental, emotional or spiritual well-being, please mention below so I can be prepared to assist if necessary. All information shared is STRICLTY CONFIDENTIAL and is required to ensure that I am prepared to support you in your healing process during the retreat.

INFORMATION RELATED TO YOGA, HIKING, SWEAT LODGE & COLD WATER IMMERSION EXPERIENCE

If you suffer from any cardiovascular illness, or are taking medication to treat any form of cardiovascular disorders or imbalances, I recommend you discuss with your medical practitioner before taking part in any of the above mentioned activities, namely sweat lodge.

There are physiological stressors we put our bodies through, to create a state of transcendence that can put strain on people who are not familiar with, or have taken part in a sweat lodge ceremony.

Please indicate your level of experience in the activities listed below:

Yoga Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced *
Yoga Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced
Hiking Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced *
Hiking Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced
Sweat Lodge Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced *
Sweat Lodge Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced
Cold Water Immersion Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced *
Cold Water Immersion Experience - 1 Heart - Beginner / 2 Hearts - Intermediate / 3 Hearts - Advanced

INFORMATION RELATED TO PLANT MEDICINE

This retreat offers participants the opportunity to partake in the use of plant medicines, for a Huachuma Hike on 23 June 2023. If you are aware of the benefits of the use of plant medicines and have spoken with me already to see if this would be a good fit, you will need to give your express consent to do so. I will ensure that you will be well taken care of and that a safe container and space is held for you to get maximum benefit.

INFORMATION RELATED TO INDEMNITY AND WAIVERS

Please read through the important information below regarding waivers, risk indemnification and confidentiality terms and conditions, and check the box below to indicate that you AGREE.

By checking the box below, I hereby acknowledge that participation and use of facilities and grounds are at my own risk, and that I assume all responsibilities for any and all aspects of participation. I have carefully read and fully understand the contents of this Indemnity Form and I fully and voluntarily agree to the Terms and Conditions set out below. *
Please Check the Box to AGREE to the Indemnity Form.

1.) ASSUMPTION OF RISK, RELEASE AND WAIVER:

1.1) I understand that there are inherent unforeseen risks involved in participating in the activities on the retreat facilitates by CHRIST LIGHT YOGA and SIMA KADE BUSH RETREAT, its owners, organisers, instructors, facilitators, employees, agents, representatives and other guests (all hereinafter known as "Releasees").

1.2) I voluntarily assume all risks associated with participating in the retreat and accept full responsibility for any and all outcomes that may arise from these activities.

1.3) I understand that attending a wellness retreat may involve voluntary participation in physical activities both indoors and outdoors, and certain exposure to wildlife and walks, steps, paths and roads that are uneven. With these, and all related activities, there is a certain element of risk.

1.4) I understand that these activities requires and includes physical movements. I realise that these activities also provide relaxation, stress relief, stress education and awareness. As with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will notify the instructor, adjust my posture and listen to my body. I will not push my body too far and will ask for support from the teacher if needed.

1.5) All of the activities offered on the retreat are not to be considered a substitute for medical care or diagnosis. The activities on offer can work well in conjunction with traditional medical care. I will partake in the activities on offer only after discussing it with my doctor and gaining their approval. I affirm that I alone am responsible to decide whether to take part in any of the activities on offer.

1.6) I, hereby agree to the following:

1.6.1) That I am participating in various activities offered by CHRIST LIGHT YOGA, where I will receive information and instruction about these activities. I understand that these activities may require physical exertion which may be strenuous and may cause physical injury. I am fully aware of the benefits and risks involved in all of these activities.

1.6.2) I understand that it is my responsibility to consult with a physician prior to and in reference to my participation in the activities on offer during the retreat. I warrant and represent that I am physically fit and have no medical condition that would prevent my full participation in the activities on offer.

1.6.3) In consideration of participating in all activities on the retreat, I agree to assume full responsibility for any risks, injury or damages, which I might incur as a result in participating in the activities.

2.) MEDICAL CONDITION(S) AND INFORMED CONSENT:

2.1) I hereby confirm that I have disclosed all relevant medical information and conditions to the Releasees.

2.2) I acknowledge that the Releasees may request additional information about my health, and I agree to provide accurate and complete information.

2.3) I have been fully informed about the potential effects, risks, and benefits of participating in the retreat and included activities, and I give my informed consent to participate.

3.) CONFIDENTIALITY:

3.1) I understand that during the retreat, participants may share personal experiences and information.

3.2) I agree to maintain the confidentiality of all information shared by other participants, respecting their privacy and the safe space created during the retreat.

4.) FINAL DECLARATION:

4.1) I, the undersigned, hereby irrevocably and unconditionally agree to indemnify and waive, release and hold harmless from liability, the Releasees, from any and all liabilities, claims, actions, damages, costs or expenses, including legal fees, of any nature whatsoever, whether in law or equity, known or unknown, occurring during, caused by, relating to, or arising from or in connection with in any way, my participation on the CHRIST LIGHT YOGA RETREAT and staying at SIMA KADE BUSH LODGE.

4.2) I also understand that this Release and Waiver of Liability irrevocably and unconditionally releases and holds harmless all Releasees from any financial or other liability for any injury, bodily harm, sickness, illness, or loss of life that I may suffer and from any harm or loss of property occurring during, caused by, relating to, or arising in any way.

4.3) I, my heirs, or legal representative forever release, waive, discharge and covenant not to sue the Releasees for any injury or death caused by their negligence or other acts.