Name *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone *

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Payment, Refund & Cancellation Policy *

By clicking this box I agree to pay in full for the retreat. I agree that payment for all products, services and special programs is required in full by JANUARY 26, 2018. MINIMUM $800 DEPOSIT DUE IMMEDIATELY. All sales are final, all payments for products and services are non-refundable, and services are non-transferable. The teacher reserves the right to terminate an individual’s enrollment in any program or membership at any time. If such termination is due, in the sole judgment of the teacher, to the unsafe, disruptive, uncooperative, negligent, reckless or otherwise improper acts or omissions of, or violation of any policy or rule is effected by the teachers for reasons other than those set forth immediately above, i.e. a service must be cancelled midterm, a prorated refund will be issued not later than 45 days after cancellation. By clicking this box, I acknowledge that I have read this release and understand all of its terms. I execute it voluntarily and with full knowledge of its significance.

I AGREE

Waiver & Release *

I represent that I am physically capable of participating in any and all activities provided by Lisa Benner (the teacher), which may include, but not be limited to yoga postures, exercise, nutrition, outdoor activities, aerial, acrobatics, stretching and breathing exercises (the “Activities”). I understand that the Activities can be strenuous and subject to risk of serious injury and undertake participation in the Activities ENTIRELY AT MY OWN RISK. I understand that the Activities should not be undertaken without the consent of a medical doctor and I am responsible for undertaking to obtain such consent. I further take full responsibility for knowing and acting within my abilities while participating in the Activities and learning and implementing any modifications needed to make the Activities safe and appropriate for me. I agree that the teacher, contractors, agents and assigns shall not be liable or responsible for any injuries to me which may occur as a result of (a) my use of all amenities and equipment provided by the teacher and my participation in the Activities, (b) the sudden and unforeseen malfunctioning of any equipment and (c) my slipping and/or falling while in the facility, or on the retreat premises, including adjacent sidewalk areas. I agree that the teacher is also not responsible for any loss of, or damage to, personal property. I expressly agree to release and discharge the teacher, contractors, affiliates, representatives, successors, assigns and instructors from any and all claims, causes of action or judgments that may arise out of the Activities and I agree to voluntarily forfeit or waive any right that I may otherwise have to bring a legal action against the teachers for personal injury or property damage. TO THE EXTENT THAT STATUTE OR CASE LAW DOES NOT PROHIBIT RELEASE FOR ORDINARY NEGLIGENCE, THIS RELEASE APPLIES TO ANY ORDINARY NEGLIGENCE ON THE PART OF RWY, ITS AGENTS, OFFICERS, DIRECTORS, CONTRACTORS, ASSIGNS, AFFILIATES, REPRESENTATIVES, SUCCESSORS, INSTRUCTORS AND EMPLOYEES. I expressly agree that this release shall be binding upon my heirs, executors, administrators and assigns. By clicking this box, I agree to this Waiver & Release, I acknowledge that I have read this release and understand all of its terms. I execute it voluntarily and with full knowledge of its significance.

I AGREE