2021 Namaspa Peru Retreat Intake
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What gender do you identify with?
Briefly share why you want to travel to Peru and participate in this retreat?
Is this your first international yoga retreat? If no, where and with whom?
Do you practice yoga? If so, how often and in what capacity?
Do you have a regular fitness routine other than yoga? If so, briefly explain.
If you do practice yoga, what teachers and leaders inspire you? If you don't practice yoga, what teachers and leaders inspire you?
Are you under the care of a physician? If so, for what condition that might affect your participation in this retreat?
Do you have injuries or physical considerations that might require additional support? If so, please briefly explain.
Do you have any food allergies or restrictions? Please list and/or briefly explain.
Do you drink alcohol? If so, how many drinks per week? We promise we are not judging you.
Do you use recreational drugs? If so, how many times per week? Ditto.
Are there any other things we should know about you, so we can support your experience on this retreat?
Please read the following agreement of release and waiver of liability. This document affects your legal rights.You must read and understand it before clicking to sign, I hereby agree to the following: 1. I am voluntarily participating in this 2020 Peru yoga retreat offered by Suzie Newcome and Brandy Berlin of Namaspa, LLC, during which time I will receive information and instruction about yoga, and participate in yoga classes and workshops (collectively referred to as “yoga”).  I recognize that yoga requires intense physical exertion which may be hazardous or strenuous and may cause serious injury, and I am fully aware of and voluntarily accept all risks and hazards involved. // 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in yoga.  I represent and warrant that my physician has approved of my participation in yoga, that I have no physical or medical condition that could interfere with my safely engaging in yoga, or that might be impacted by or prevent my participation in yoga. I agree that if at any time I should suffer from any such physical or medical condition, I will immediately notify my instructor. 3.  // In consideration of being permitted to participate in Namaspa’s yoga in Peru, I agree to accept and assume full responsibility and liability for any and all risks, injuries or damages, known or unknown, which may result or that I might incur as a result of participating in any yoga or program offered by Namaspa, LLC. // 4. I fully understand that I may injure myself as a result of my participation in Namaspa, LLC’s yoga. In consideration of my participation in Namaspa’s yoga, I hereby fully and voluntarily release, waive and discharge Namaspa, LLC (and each of its members, managers, employees, owners and individual instructors (collectively “Namaspa”) from any and all claims, demands, actions or liability of any kind whatsoever, known or unknown, either now or in the future, including but not limited to any physical or emotional injury, heart attacks, muscle strains, pulls, tears, broken bones, shin splits, heart prostration, knee, lower back or foot injuries and any other illness, soreness or injury however caused, occurring during or after my participation in Namaspa, LLC's yoga program. To the maximum extent allowed by law, I agree not to initiate any legal action or claims against Namaspa in connection with any claims which could have been or could be raised in any way connected with or arising out of my participation in Namaspa’s yoga retreat.// By clicking and therefore signing this document, I acknowledge that if I am hurt or damaged as a result of my participation in the 2020 Peru retreat and Namaspa’s yoga, I may be found by a court of law to have waived my right to maintain a lawsuit against Namaspa on the basis of any claim I have released as part of this Agreement.  I have had sufficient opportunity to read this entire document, and to ask questions.  I certify that I have read and fully understand its contents. I voluntarily agree to the terms and condition stated above. *
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